Cervical Biopsy

Punch biopsy.

To evaluate abnormal cervical tissue found during a Pap smear or colposcopy.

A sample of the tissue is removed for study in a pathology laboratory.

• The physician will try to schedule you for the biopsy about one week after your menstrual period. (If you have your period at the time of the scheduled biopsy, you should reschedule.)
• Before the procedure, you undress from the waist down and don a surgical gown.

• Your doctor does a colposcopic exam (see above).
• The doctor then uses a small, scissors-like instrument called a punch to snip one or more tiny pieces of tissue (less than a ¹/₄ of an inch in size) from your cervix.
• The specimen is sent to the pathology lab for analysis.

• Loop electrical excision of the transformation zone (LETZ). Rather than using a punch, in this procedure the doctor uses an electrocautery loop to remove a cervical tissue sample for biopsy.
• Endocervical curettage. Following a punch biopsy, your doctor may also take a sample of the tissue lining the endocervical canal, which is just past the opening of the cervix (cervical os) but not in the uterus itself. This is a precaution against missing any abnormal tissue in this area, which cannot be fully seen with the colposcope. A small, spoon-shaped instrument called a curette is inserted into the canal and briefly scraped against the lining. Although the procedure lasts only a few seconds, it may cause cramping.

• You dress and are free to leave.
• You may experience cramping after the procedure, so plan to take some time off to rest. (Ask if you can take a mild analgesic about half an hour before the procedure to lessen the cramps later.)
• Plan to wear a sanitary napkin for the first 24 hours or so after the biopsy.
• Avoid strenuous activity, douching, and sexual intercourse for at least 24 hours.
• You may experience bleeding or an unpleasant vaginal discharge for a day or so. This is usually not a cause for concern, but you should report any excessive bleeding immediately.

Inadequate sample.

A pathologist studies the tissue for abnormal cells and submits a report to your referring physician.

The test makes available the actual abnormal tissue for analysis.

It's invasive.

• If the tissue is normal, you may receive a clean bill of health or undergo further tests to determine the cause for the original referral. You may, however, be scheduled for Pap tests at closer intervals than persons with normal Pap test results.
• Abnormal tissue may indicate an infection or possible cancer. You may be referred for further tests to confirm the diagnosis, or treatment may be begun.