If your doctor discovers an ovarian mass during an exam or suspects an abnormality related to the ovary, a pelvic exam, ultrasound, and CA-125 test (a blood test that screens for a protein that is often elevated in the bloodstreams of women with ovarian cancer) are the first steps in making a diagnosis.
An ultrasound can reveal characteristics about masses that may help doctors determine if they are benign cysts or potentially cancerous. During the ultrasound, characteristics about the mass are noted, like appearance, fluid content, solidity, whether it has spread, and if the other ovary also contains a mass. Based on these characteristics, the radiologist assigns a score of the ultrasound that contributes to the risk of malignancy index (RMI).
The RMI is a scoring systems that determines the risk of a mass being cancerous. The ultrasound score is combined with a score that evaluates menopause status and the results of the CA-125 tumor marker test. The sum of these numbers reveal how high of a risk that the mass is cancerous. Keep in mind that the RMI only determines the risk of it being cancer, it is not a diagnosis. It may not be used for all types of cancer in helping to make a diagnosis.
A biopsy is necessary to confirm the presence of cancer and involves removing small tissue samples to be evaluated later under a microscope. An ovarian biopsy can be done surgically through a procedure called a laparotomy. During a laparotomy, the surgeon makes an incision into the abdomen and looks for signs of cancer in the abdominal cavity. This includes taking a biopsy or possibly removing an ovary for further evaluation by a pathologist. If cancer is obvious, the surgeon may try to remove as much of it as possible. This is called debulking, and is a common method of treating ovarian cancer.
An ultrasound can reveal characteristics about masses that may help doctors determine if they are benign cysts or potentially cancerous. During the ultrasound, characteristics about the mass are noted, like appearance, fluid content, solidity, whether it has spread, and if the other ovary also contains a mass. Based on these characteristics, the radiologist assigns a score of the ultrasound that contributes to the risk of malignancy index (RMI).
The RMI is a scoring systems that determines the risk of a mass being cancerous. The ultrasound score is combined with a score that evaluates menopause status and the results of the CA-125 tumor marker test. The sum of these numbers reveal how high of a risk that the mass is cancerous. Keep in mind that the RMI only determines the risk of it being cancer, it is not a diagnosis. It may not be used for all types of cancer in helping to make a diagnosis.
A biopsy is necessary to confirm the presence of cancer and involves removing small tissue samples to be evaluated later under a microscope. An ovarian biopsy can be done surgically through a procedure called a laparotomy. During a laparotomy, the surgeon makes an incision into the abdomen and looks for signs of cancer in the abdominal cavity. This includes taking a biopsy or possibly removing an ovary for further evaluation by a pathologist. If cancer is obvious, the surgeon may try to remove as much of it as possible. This is called debulking, and is a common method of treating ovarian cancer.
A less invasive surgery, laparoscopic surgery, may also be an option for some women instead of a laparotomy. Laparoscopic surgery involves the surgeon making a small incision into the abdomen. A laparoscope (a fiber optic rod equipped with a light and camera) is inserted through the incision and transmits live video feed to a monitor.
If cancer is confirmed from the biopsy, the stage and grade of ovarian cancer is then determined. For women with suspected advanced stages of ovarian cancer, then additional tests, like imaging tests are required to stage the disease.
source : cancer.about.com
