A cervical biopsy is the removal of a suspicious sample of the cervix to check for the presence of abnormal cells, including cancer. The cervix is the lower part of the uterus (womb), where it opens into the vagina. A cervical biopsy may be recommended if you have an abnormal Pap smear or pelvic exam. Depending on the circumstances, a cervical biopsy can be done in a healthcare provider's office or operating room with medication to help you relax. The type of biopsy your healthcare provider recommends, as well as available facilities and resources, will determine where it can be performed.

• Cervical punch (cone) biopsy - This biopsy is usually done in a hospital or ambulatory surgery center. You may be given medication to help you relax or sleep (anesthesia). During the procedure, a cone-shaped piece of the cervix is removed for examination under a microscope. This procedure can be seen as a primary treatment if all the abnormal tissue is removed.

A colposcopy can be uncomfortable, but not usually painful. When a sample is taken, you may feel a pinching. Cramping and slight bleeding after the biopsy is common.

This care path includes the costs for a cone biopsy performed in an outpatient facility.

Routine Pap smears have decreased the incidence of cervical cancer in the United States. This is because cervical cancers typically evolve slowly and Pap spears can detect pre-cancerous lesions when they are treatable. Some of the risks factors for cervical cancer include:

• HPV (human papilloma virus) – Certain strains of the HPV virus are the most common cause of cervical cancer. HPV is spread during sexual intercourse. A vaccine has been developed to prevent HPV infection and decrease the chance of cervical cancer.
• Sexual activity - You began having intercourse at an early age.
• High-risk sexual activity - You or your partner have multiple sex partners or engage in other high-risk sexual activities.
• Smoking - You are a smoker.
• DES exposure - Your mother took a synthetic estrogen called diethylstilbestrol (DES) when she was pregnant. In the past, DES was given to pregnant women to prevent miscarriage and other pregnancy complications. Daughters exposed to DES before birth have an increased risk of developing vaginal or cervical cancer.
• Weak immune system - Your immune system is weak due to medications or illness.
• Lower economic status - May be due to lack of insurance and inability to pay for routine pap smears.

Things you can do to decrease your risk of developing cervical cancer, or catch it at a very early (curable) stage, include:

• Getting routine pap smears, as recommended by your healthcare provider.
• Being vaccinated with the HPV vaccine, as recommended by your healthcare provider.
• Practice safe sex (use a condom).
• Limit the number of sexual partners.
• Do not have sex with people that engage in high-risk sexual activity.

There are frequently no symptoms in the early stages of cervical cancer. When present, symptoms can include:

• Constant vaginal discharge that may smell badly and vary in color from pale to brown
• Vaginal bleeding between menses or after sexual activity
• Vaginal bleeding after menopause

As the cancer advances, other symptoms can develop. These include:

• Decreased appetite and weight loss
• Feeling tired all the time
• Lower back and leg pain
• A leg that is swollen
• Inability to hold urine or stool

Contact your healthcare provider if you have any of the symptoms noted above. He or she will perform a physical examination and Pap smear to see if there are any abnormal cells on your cervix. They may also recommend one of the following tests:

• Endocervical curettage (ECC) to examine the passageway inside the cervix
• Removal of tissue for examination under a microscope (biopsy)

A biopsy is needed to determine if an abnormality is cancer. If your cervical biopsy indicates you do have cervical cancer, additional testing may be needed.

If your healthcare provider recommends a cervical biopsy, prior to the procedure tell them about any medications you are taking (including over-the-counter medications and supplements). You should also ask about specific instructions to follow before and after the procedure. These include:

• Medications you should not take before the procedure, such as blood thinners
• Regular medications you should continue to take on the day of your procedure
• How many hours you should stop eating and drinking before the procedure
• Activities you should not participate in just before or after the procedure (such as sexual activity and douching)

Empty your bladder and bowels before the procedure. Take slow deep breaths during the procedure to help you relax.

Contact your healthcare provider if you have symptoms of cervical cancer. Be prepared to discuss your symptoms and how long you have had them.

• Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
• Make a list of your medications (including over-the-counter).
• Write down any questions, symptoms or concerns you want to talk about.
• If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a cervical biopsy?

• What is my diagnosis and reason for the surgery? Are there any alternatives? What are the benefits and risks of each?
• What are the possible complications for this surgery?
• What happens if I do not go through with the surgery?
• What is your experience in doing this type of surgery? What is your complication rate?
• Will I need anesthesia? What are the possible side effects?
• How will I feel after the surgery? Will I have to modify my activity?
• How long do to I have to avoid douching or sexual intercourse?

After your surgery, you should know what you had done, what medication was given, and what symptoms you should report to your healthcare provider after discharge. You should also understand all home care instructions (including medications and side effects) and follow-up plans. Your surgeon should also communicate with your primary care physician.

Source UHC.com

Also known as:

Cervix Biopsy

Cancer

Biopsy - Cervix

Biopsy