Targeted biopsy under a colposcope
After extended colposcopy, the doctor selects the most changed areas (acetowhite epithelium, iodine-negative zones, atypical vessels) and takes a 2-4 mm fragment from each with a conchotome or radio wave loop; if necessary, supplemented by curettage of the cervical canal. Bleeding is stopped with a tampon or coagulation. The procedure is performed in the first phase of the cycle immediately after menstruation, with a clean smear. The histologist's conclusion determines the tactics: CIN 1 - observation and repeat cytology in 6-12 months, CIN 2-3 - excision or conization, cancer - treatment by a gynecological oncologist.
Indications
- abnormal colposcopic picture, HSIL/ASC-H in cytology, HPV 16/18 with changes - cervical biopsy;
- endometrial hyperplasia by ultrasound, bleeding, bleeding in menopause, control of treatment of hyperplasia - endometrial biopsy;
- infertility, unsuccessful IVF - assessment of chronic endometritis and receptivity;
- atypical glandular cells, suspicion of canal pathology - curettage of the cervical canal;
- breast formation by ultrasound/mammography (BI-RADS 4–5) - breast biopsy.
Why is histology needed?
Only examination of the tissue under a microscope gives a final diagnosis: the degree of cervical dysplasia (CIN 1–3) or carcinoma, the type of endometrial hyperplasia (with or without atypia), chronic endometritis, benign or malignant breast formation. Tactics depend on the result - observation, conservative treatment, conization, hormonal therapy, surgery. Modern methods (pipel, vacuum and core needle biopsy, colposcopic targeted biopsy) make it possible to obtain material on an outpatient basis in minutes with minimal trauma.
