Cervical Biopsy

Definition of Cervical Biopsy

A cervical biopsy involves the removal of a small sample of tissue from the cervix. The cervix is the lowest part of the uterus and contains the opening from the uterus to the vagina. The tissue sample is called a biopsy.

Who is a candidate for the procedure?

A cervical biopsy is done to detect cancer or precancerous changes of the cervix. The cervical biopsy is a next step in diagnosis after abnormal cells have shown up on a Pap smear that is done as part of a woman's pelvic examination.

A Pap smear is a test in which the provider uses a small spatula and a brush to gently scrape cells from the woman's cervix. These cells are sent to a lab for testing. The Pap smear may show early, abnormal, cancer-like changes in the cervix cells.

A colposcopy is an examination of the surface of the cervix through a magnifying scope. It gives more accurate diagnostic information than a Pap smear.

A woman should have a colposcopy, as well as a cervical biopsy, if one of the following conditions applies:

• She has 2 consecutive mildly abnormal Pap smears and is older than 30 years
• She has one moderately or severely abnormal Pap smear
• She has a suspicious-looking lesion on the cervix or vagina, with or without an abnormal Pap smear
• She has extensive genital warts on her vulva, which are the lips at the opening of the vagina
• She was exposed to DES, or diethylstilbestrol, in her mother's uterus. Diethylstilbestrol, a potent medication to prevent miscarriages, has been associated with abnormal changes in the cervix of women exposed as fetuses.

If necessary, a healthcare professional may safely perform a cervical biopsy on a pregnant woman. Usually, however, the procedure can wait until after the delivery of the infant.

How is the procedure performed?

A cervical biopsy is done with the woman lying on her back with her feet in stirrups. The healthcare provider places a speculum inside the woman's vagina. This instrument helps enlarge the opening of the vagina, which allows the provider to see the cervix and vaginal interior.

The healthcare professional uses a colposcope to magnify and examine the cervix and vagina. To make cells more visible under the colposcope, the examiner puts a mild solution of vinegar, or sometimes a solution of weak iodine, on the area.

Then, the examiner takes small bits of tissue, or a biopsy, from suspicious areas. The technique is called cervical punch biopsy. The woman may feel a brief pinch or cramp. The healthcare professional records the location of the abnormal areas and sends the tissue sample or samples to be viewed under a microscope in the lab.

What happens right after the procedure?

Cramping usually passes within minutes of the cervical biopsy. Lying down for a few minutes after the procedure can prevent the woman from feeling lightheaded when she sits up. Any further cramping may be treated with an over-the-counter pain medication such as acetaminophen (i.e., Tylenol) or ibuprofen (i.e., Motrin).

The healthcare professional discusses the pathologist's findings with the woman. Abnormalities can range from mild cervical dysplasia, or slightly abnormal changes in the cells examined, to cancer of the cervix. Treatments and follow-up depend upon the exact diagnosis.

What happens later at home?

For 1 to 2 days after a cervical biopsy, the woman may have a small amount of pinkish discharge from the vagina. For 2 to 3 days afterwards, she should avoid sexual intercourse, douches, and tampons.

What are the potential complications after the procedure?

A woman may experience minor bleeding after a cervical biopsy. Other potential complications include heavier vaginal bleeding, infection, or allergic reaction to the iodine used in the procedure. Any new or worsening symptoms should be reported to the healthcare professional.