How is vulvar cancer diagnosed?

Your healthcare provider may find signs of vulvar cancer during a routine pelvic exam. You may not have any symptoms. A Pap test and a human papillomavirus test will likely be done. Diagnosing vulvar cancer starts with your healthcare provider asking you questions. You'll be asked about your health history, symptoms, risk factors, and family history of disease.

It’s very important that you see an expert. Gynecologic oncologists are specialists in diagnosing, treating, and checking for female cancers, including vulvar cancer. Your healthcare provider may have you see one of these cancer experts to find out for sure what’s causing the changes in your vulva. If this provider thinks you might have vulvar cancer, you’ll need a biopsy to be sure.

What is a biopsy?

If your healthcare provider sees an abnormal or changed area, you may need a biopsy. It's the only way to know for sure if you have cancer.

A biopsy is done by removing a tiny piece of tissue from the changed area. Medicines will be used to make your vulva numb first. If the abnormal area is small, your healthcare provider may remove all of it. If it's big, a small piece of it can be taken out by using a tool that looks like a tiny apple corer. (This is called a punch biopsy.) You might need stitches after a biopsy. You may feel some pressure, but should have little or no pain.

For larger areas, your healthcare provider may cut out a small part of the skin with a scalpel. The edges of your skin may then be stitched together. In most cases, your healthcare provider will also remove an edge of normal skin around the abnormal area.

Your healthcare provider may use a magnifying tool called a colposcope to get a close look at the changed area. The colposcope stays outside your body. It lets your provider see even small changes on your vulva. Your provider may put a vinegar-like solution on your vulva to make the changed areas white. This makes them easier to see and remove.

The removed tissue sample is sent to a lab. There, a healthcare provider called a pathologist tests the samples to look for cancer cells. It often takes about a week for your healthcare provider to get the results from the lab.

Getting your test results

When your healthcare provider has your biopsy results, they will contact you. Your provider will talk with you about other tests you may need if vulvar cancer is found. Make sure you understand the results and know what you need to do next.