The procedure is carried out if oncology or even ordinary erosion is suspected (gynecologists often send all patients with erosion to be “cauterized” with a laser, but ideally they should do this only after a series of tests). In addition, this action is often prescribed without any indication at all: for example, a biopsy for erosion, which proceeds without complications, colposcopy and ectopia are completely unnecessary.

Before your gynecologist gives you a referral, you should definitely have a colposcopy. If the results revealed areas of the epithelium colored white (this is checked with acetic acid), the woman is prescribed a biopsy. We repeat once again: this is not done in case of erosion!

If you suffer from acute inflammatory diseases, a biopsy can only be performed after complete recovery. Women with bleeding disorders should avoid such procedures if possible.

How to prepare for the procedure?

First of all, visit a gynecologist and get a smear to make sure there are no infections. In addition, hepatitis C and human immunodeficiency virus should be done. After the test, a small wound will remain in the area. This is one of the reasons why an operation such as a cervical biopsy for erosion is not performed. Ideally, the wound should heal before the woman begins her period. That is why the procedure is usually prescribed in the first phase of the cycle. You should not do it before the start of menstruation: an infection may get into the wound and the tissue will become inflamed.

Biopsy methods

Perhaps the most common method among doctors is to take a piece of tissue with a scalpel; then sutures are placed at the site from which the tissue is taken. Another biopsy method is a radio wave loop (the Surgitron apparatus is used). The disadvantage of this option is that the piece of tissue taken may be damaged, making histology difficult. In addition, the woman may experience vaginal discharge for about ten days afterward. However, we should not forget that this method is much less painful and completely non-traumatic. Therefore, if you have a high-ranking doctor, he will prescribe it for you.

What should you not do after the procedure?

After taking tissue for analysis, do not use tampons or have sexual intercourse for at least a month. You should also refrain from visiting the bathhouse, sauna, or taking a hot bath. Don't lift heavy objects or overexert yourself at all. If the biopsy did not give results, and unpleasant symptoms continue to bother you, it is quite possible that you have nothing more than cervical erosion after childbirth. In this case, the gynecologist will prescribe appropriate treatment.

A cervical biopsy is a diagnostic procedure that involves taking a section of tissue from a given structure for the purpose of further examination under a microscope. Only with the help of this study can you find out whether there are cancerous or precancerous abnormalities in the cervix, or whether it is a viral pathology. The results of this study allow us to prescribe adequate therapy for the existing condition.

The essence of manipulation

A biopsy is fundamentally different from colposcopic and ultrasound examinations, when the doctor examines the cervix with his own eyes or using ultrasound, and in the case of colposcopy, he can also conduct tests to check for atypical areas. It is similar to cytological diagnostics, only in the case of a biopsy it is not washed away, but the tissue sample is sent for histology.

After the area “suspected” of cancer has been removed from the entire tissue (this is a biopsy), it is stained with special dyes and examined under a microscope. If necessary, a histologist can also perform tests on the tissue sample that will help him establish an accurate diagnosis.

Indications

A cervical biopsy is performed:

• if the iodine test performed during colposcopy reveals areas that are not stained with iodine;
• according to the acetic acid test performed during colposcopy, the appearance of white zones was noted;
• after receiving a questionable Pap smear, which was prescribed after the detection of other cervical pathologies: condylomas, ectropion;
• if a positive test response was received for oncogenic papillomaviruses.

The main purpose of a biopsy is to detect cancer or conditions that may develop into it.

Contraindications

Biopsy is not performed:

• with hypocoagulation (extension of blood clotting time, decrease in prothrombin index, INR);
• if there is an inflammatory process in the vagina, uterus or cervix;
• during menstrual bleeding;
• during pregnancy.

Preparation

Before the study, the woman undergoes the following tests:

1. blood for structural antigens of viral hepatitis, immunoglobulins for HIV;
2. vaginal smears to determine the level of inflammation;
3. and PCR examination of a smear from the cervical canal;
4. 2 days before the analysis, ensure sexual rest (you will need to abstain from sex for 10 days after the biopsy);
5. do not douche or use tampons for two days;
6. You need to stop drinking and eating 12 hours before, as pain relief will be carried out.

The procedure is prescribed 5-6 days after the start of menstruation. Just during this period, the cells were already sufficiently renewed after menstruation; in addition, there is time for complete healing of the tissue defect.

A woman must definitely warn the doctor conducting the study about the presence of a drug allergy or hypersensitivity to latex.

How is the procedure performed?

To perform the procedure, the woman is released from work for 1-2 days. The manipulation can be performed both on an outpatient basis under local anesthesia, and in the operating room of the gynecological department, when intravenous, epidural anesthesia or general anesthesia is performed. The type of anesthesia depends on how the procedure will be performed.

A biopsy can be performed using the following methods:

1. Pipelle biopsy. This is the most gentle method. To perform it, a pipette, a special soft pipette, is inserted into the cervix. By creating negative pressure in it, a certain number of cells are obtained, which are examined under a microscope.
2. A puncture biopsy is the “gold standard” for examining areas suspicious for cancer. The procedure consists of puncturing the tissue with a special needle, in which the tissue being examined is then found in the form of a column. The manipulation is performed within a few minutes and is almost always painless. After it is carried out, there may be a slight discharge of ichor and blood for several days.
3. Biopsy using the Surgitron device - a radioknife. In this case, the suspicious area is removed using radio wave exposure. The procedure is performed for women who are planning a pregnancy in the future, since the violation of the architectonics of the cervical tissue is insignificant. It is performed on an outpatient basis and anesthesia is rarely required.
4. Loop biopsy. After administering a local anesthetic, the desired tissue sample is removed using a loop through which an electrical current is passed.
5. Laser excision – removal of tissue for microscopy is performed using a laser. The procedure is performed in a hospital under intravenous anesthesia.
6. Wedge biopsy - cutting out not only the suspicious area, but also nearby tissues using a scalpel. It is performed in a hospital and requires general anesthesia or spinal anesthesia.
7. Circular biopsy is also performed in an inpatient setting. To do this, a fairly large area is removed with a scalpel or radio knife, which includes both healthy tissue and part of the cervical canal.
8. Curettage. Using a special long-handled knife (curette), the cervical-uterine canal is scraped out. The procedure is performed after the administration of a local anesthetic drug.
9. A conchotome biopsy is performed after introducing Lidocaine into the cervix using a conchotome instrument - special scissors with pointed ends.

After the procedure

To minimize the risk of complications, follow these rules after you have a cervical biopsy:

• exclude sexual relations for 2 weeks;
• do not lift weights exceeding 3 kg;
• do not douche;
• use pads rather than tampons;
• do not take a horizontal position in the water - wash in the shower;
• do not take medications that affect blood clotting;
• do not visit the bathhouse/sauna.

If after the manipulation there is a strong pull in the lower abdomen, you have to change pads frequently, blood clots come out, the temperature has risen or there is an unpleasant smell of discharge - consult a doctor. If this happens at night, call an ambulance.

Complications of the procedure

Biopsy, except for puncture and pipel variants, is not at all a routine manipulation and can be complicated:

• damage to the vessel with the development of bleeding of varying severity;
• suppuration of a postoperative wound;
• with a circular or wedge-shaped biopsy, extensive scars or areas in which abnormal epithelium grows for this localization may develop, which will be considered a precancerous condition.

Invasive diagnostic methods are used only in cases where other methods have failed to obtain the desired result. However, to make or exclude an oncological diagnosis it is always necessary cervical biopsy. Without this examination, it is difficult to say for sure whether a benign or malignant tumor is found in the patient.

How dangerous is cervical cancer?

Cervical cancer is common among women of all ages, including those of childbearing age. Any malignant formation is dangerous because it can spread throughout the body and disrupt the functioning of internal organs, causing exhaustion and death. Therefore, cancer is treated aggressively and is necessarily accompanied by surgery.

The danger of cervical cancer is that it affects young women. Surgical treatment at any stage, except for cancer “in situ” (incipient tumor located within the epidermis), involves the need to remove the cervix and uterus with ovaries. Naturally, after such treatment the woman will not be able to have children.

Detection of a tumor at an early stage provides a chance to use organ-preserving treatment while preserving reproductive function. To prevent the disease from progressing, you should be observed annually by a gynecologist and treat any identified pathologies.

What is a biopsy and what does it show?

It is a method for studying the cellular composition of the skin, mucous membranes and internal organs. Each organ normally has its own cellular structure; stratified squamous epithelium is typical for the cervix. Under certain pathological conditions, this epithelium can change - dysplasia develops and. In the most complex cases, against the background of normal cells of stratified squamous epithelium, malignant cells appear, which are responsible for the growth and development of a cancerous tumor.

During a biopsy, tissue is taken from the organ being examined. A small number of cells is required for diagnosis - the organ does not experience any failure after the biopsy. Then the taken material is processed and prepared. The finished preparation is laid out on glass slides and examined under a microscope. Afterwards, the doctor makes a conclusion about the quality of the cellular composition of the examined area.

Indications for cervical biopsy

A cervical biopsy is performed in the following cases:

1. Dysplasia is the appearance among the stratified squamous epithelium of cells prone to atypical degeneration. The disease refers to.
2. Leukoplakia is the appearance of areas of keratinization, which is not typical of the cervix. Pathology also refers to precancerous.
3. , are benign neoplasms that can develop into cancer.
4. Ectopia - the presence of erosive, bleeding areas.

Indications for a biopsy are determined by performing colposcopy - a non-invasive instrumental examination of the cervix. In this case, the cervix is ​​examined under a colposcope - an optical device that magnifies the area being examined several times.

Contraindications

It is prohibited to carry out the procedure in the following conditions:

• Active inflammation of one of the pelvic organs (colpitis, myometritis, adnexitis and others);
• Pregnancy (first and third trimester), in the second trimester, if indicated, the procedure can be performed;
• Acute infections of any location;
• Reduced blood clotting;
• Severe somatic pathologies (heart and vascular diseases, respiratory system disorders).

How painful is the procedure?

The pain sensation depends on where in the cervix the doctor takes the biopsy and how extensive the tissue sampling will be. With superficial sampling of a small area, the patient only notices discomfort, and tissue sampling in the isthmus area will most likely be painful.

The patient’s mood plays a role in the nature of the sensations during manipulation. The uterus and its cervix are practically devoid of pain receptors, therefore, having properly adjusted herself to the procedure, a woman will not feel pain.

How is a cervical biopsy performed?

A cervical biopsy is performed using a colposcope to specifically enlarge the cervix and highlight the pathological focus. In order to better visualize suspicious areas, the doctor stains the cervix with iodine or a solution of acetic acid, which changes the color of the painful areas.

Then the biopsy is performed directly - the doctor uses a special needle or other instruments to separate a section of tissue and place the collected material in a solution with formaldehyde, which is sent to a histology laboratory. Then the collection site is treated with an antiseptic. There is no need for sutures as the damage is minor. The patient should rest for about half an hour, after which she can go home. After 2-3 weeks, you should return for a follow-up appointment to examine the cervix and assess the nature of wound healing.

Preparing for a cervical biopsy

Two days before the biopsy you should:

1. Stop sexual intercourse.
2. Do not use tampons or douche.
3. Do not use vaginal suppositories without consulting a gynecologist.

Before the procedure, you should perform toilet of the genitals.

Before the material is collected, contraindications should be excluded. Therefore, a blood and urine test is required, as well as a smear from the cervix for flora. Also, a smear is taken for atypical cells, and tests are taken for some infections. Older patients undergo a consultation with a therapist, where they undergo an ECG.

Possible complications and consequences

After a biopsy, the patient may develop the following reactions:

• Increased body temperature;
• Lower abdominal pain;
• Weakness, deterioration of general condition;
• Discharge of green mucus and blood.

These consequences indicate the development of complications such as bleeding and secondary infection. These complications are rare and are excluded if the biopsy was performed by a competent specialist.

Long-term consequences may include cervical stenosis and weakness. The latter complication leads to premature birth, and cervical stenosis is dangerous for infertility. Therefore, for young, nulliparous girls, a biopsy is performed only if there are strict indications and with the collection of a small amount of material. The safest is radio wave biopsy, and the most traumatic is wedge-shaped conization of the cervix.

What to do if there is discharge after a cervical biopsy?

If, after the examination, heavy bloody or mucopurulent discharge appears, you should immediately contact a gynecologist. You should not self-medicate, use any suppositories, apply cold to your stomach, etc. The doctor will examine you and prescribe treatment.

After the procedure, you should check with your doctor to see if there may be any discharge that is considered normal. Depending on the extent of the study, the next 2-3 days after the biopsy, bloody and mucous discharge appears. It is important that you can only use pads; the use of tampons is prohibited for 2 weeks after taking a biopsy.

Recovery after

In order to speed up healing and avoid the development of negative reactions, within two weeks after the diagnostic procedure you should:

1. Avoid using tampons.
2. Avoid sexual contact.
3. Do not swim in ponds, pools, or the sea.
4. Avoid taking blood thinning medications (if these medications were prescribed by a specialist in another field, this issue should be discussed with him).
5. Do not lift a load heavier than 3 kilograms.
6. Do not go to the sauna, do not take a bath, do not take a hot shower, do not be in the sun, i.e. completely eliminate overheating of the body.

After this period, a consultation with a gynecologist usually follows. Most likely, the area where the biopsy was taken will have healed and the recovery period will be over.

Prices for BShM

The cost of a cervical biopsy (sampling of material) in Ukraine costs about 400 – 500 UAH. depending on the method of collecting material and the level of the clinic. A biopsy with pathohistological examination costs from 800 UAH. up to 2000 UAH, which again depends on the level of the medical center.

The price of a diagnostic procedure together with a pathohistological examination in Russia averages 6,000 rubles.

conclusions

The main advantage of the technique is the ability to confirm or exclude oncological pathology. If there is a suspicion of cancer, then a study is worth conducting. Early diagnosis is the key to successful, organ-preserving treatment. Cervical biopsy is an extreme method in examining a woman, but the data it provides cannot be compared with data from other diagnostic methods.

A cervical biopsy is a gynecological examination that allows you to clarify the diagnosis if you suspect or.

Why is a cervical biopsy performed?

This analysis is necessary if suspicious changes have been detected in the cervix. A biopsy helps the doctor understand whether the cells in the cervix are benign (normal) or malignant (cancerous). Depending on the results of the biopsy, the gynecologist will formulate further treatment tactics.

Who needs a cervical biopsy?

the presence of suspicious changes in the cervix during (acetowhite epithelium, iodine-negative areas, atypical vessels, the presence of rough mosaics and punctuation, etc.)

On what day of the cycle can a cervical biopsy be done?

The most favorable days of the menstrual cycle for performing a cervical biopsy are days 7-13 (the first day of the cycle is considered the first day of menstruation). It is better to do a biopsy immediately after the end of your period, so that the wound on the cervix has time to heal by the beginning of the next menstruation.

How to prepare for a cervical biopsy?

To reduce the risk of biopsy complications, use the following recommendations from gynecologists:

avoid sex 2 days before cervical biopsy

tests for hidden infections (,)

tests for HIV infection, viral hepatitis, syphilis

Contraindications to cervical biopsy

If during the examination you are found to have inflammatory diseases of the vagina or cervix, the biopsy will have to be postponed until the inflammation goes away.

Your gynecologist may order additional tests to determine the cause of the inflammation, or may prescribe treatment right away if the cause of the inflammation is clear.

A cervical biopsy should not be done during menstruation.

If you suspect you are pregnant, be sure to tell your doctor.

Is it possible to have a cervical biopsy during pregnancy?

In some cases, a cervical biopsy may be required during pregnancy. If your gynecologist notices suspicious changes in the cervix and concludes that waiting until after birth may be dangerous, a biopsy may be done during pregnancy.

A cervical biopsy in the early stages of pregnancy (up to 12 weeks) may slightly increase the risk of miscarriage, and in later stages of pregnancy it can provoke, therefore gynecologists recommend performing a biopsy in the second trimester of pregnancy, when the risk of complications is lowest.

If the gynecologist considers that the detected changes in the cervix do not require immediate diagnosis, then the cervical biopsy can be postponed and done 6 weeks after birth.

What types of cervical biopsy are there?

There are several different methods for performing a cervical biopsy, so be sure to ask your gynecologist which method is right for you.

The choice of biopsy method depends on the preliminary diagnosis and several other factors known to your gynecologist. Some types of biopsy are not only a diagnostic method, but also a method of treating cervical pathologies.

Colposcopic (targeted, puncture) biopsy of the cervix

This is the most common method of cervical biopsy, which is considered the “gold standard” in the diagnosis of cervical dysplasia and cancer.

A targeted biopsy of the cervix is ​​carried out during colposcopy, and those areas of the cervix that seem suspicious to the doctor are taken for analysis. To collect the material, a special needle is used, which takes a “column” of cervical tissue containing all the cell layers necessary for the study.

A needle biopsy does not require hospitalization and can be performed in a gynecologist's office. This type of biopsy does not require general anesthesia and is usually performed without any pain relief. During the biopsy, you may experience discomfort, pressure, or tingling that lasts no more than 5-10 seconds.

After a colposcopic biopsy, bleeding from the vagina may appear, which lasts no more than 2-3 days.

Conchotomic cervical biopsy

Conchotomic biopsy is not much different from the targeted biopsy described above. The only difference is that for a conchotome biopsy, not a needle is used, but a special conchotome instrument, which looks like scissors with pointed ends.

Conchotomic biopsy does not require hospitalization. In order to reduce pain, you will be given local anesthesia shortly before the material is collected.

Spotting may occur for several days after the conchotomy biopsy.

Radio wave biopsy of the cervix (biopsy with the Surgitron apparatus)

Radio wave biopsy does not cause significant damage to cervical tissue and is associated with a low risk of complications.

This method of biopsy of the cervix is ​​performed with a special instrument sometimes called a radioknife. In Russia and the CIS countries, the Surgitron device is used to perform radio wave biopsy.

Biopsy with Surgitron does not require general anesthesia and can be performed in a gynecologist's office. After a radio wave biopsy, there is virtually no bleeding, or it is not profuse and lasts no more than 2-3 days.

The risk of scarring on the cervix after a radio wave biopsy is extremely small, and therefore this type of biopsy is recommended for girls and women who are planning a pregnancy in the future.

Laser biopsy of the cervix

In a laser biopsy, areas of cervical tissue are removed using a laser knife (laser).

Laser biopsy is performed in a hospital setting because the procedure requires a short general anesthesia.

This biopsy method is considered low-traumatic and rarely causes any complications. For several days after the biopsy, you may experience some spotting (red, brown, pink) discharge.

Loop biopsy of the cervix

Loop biopsy is also called electrosurgical biopsy or electroexcision. Some countries use English abbreviations for this type of biopsy: LEEP or LETZ.

The essence of a loop biopsy is that suspicious areas of the cervix are peeled off with an instrument similar to a loop through which an electric current is passed.

Electroexcitation can be performed in a gynecologist's office. This procedure does not require general anesthesia, but local anesthesia is required.

For several weeks after electroexcision, bleeding of varying degrees of abundance may be observed.

It is believed that electrosurgical loop biopsy of the cervix may cause scar formation on the cervix. Such scars in the future may become an obstacle to conceiving a child or to carrying a pregnancy to term. In this regard, electroexcision is not recommended for young girls and women who are planning a pregnancy in the future.

Wedge biopsy of the cervix (cervical conization, knife biopsy, cold knife biopsy)

During a wedge biopsy, the gynecologist removes a triangular piece of the cervix in such a way as to obtain the most informative areas of the cervix for further examination. This type of biopsy is sometimes called an extended biopsy because, unlike a targeted biopsy, not only suspicious areas of tissue are removed for examination, but also nearby tissue that appears healthy. Conization of the cervix can be used not only as a diagnostic method, but also as a method of treatment for certain pathologies of the cervix.

To perform a wedge biopsy, a regular surgical scalpel (knife) is used, which is not heated by either current or radio waves, so this method is sometimes called a knife or cold-knife biopsy.

A wedge biopsy requires anesthesia (general anesthesia, spinal or epidural) and the procedure is performed in a hospital. After cervical conization, you may be discharged the same day or the next day.

For several weeks after the biopsy, you may experience pain in the cervical area, as well as spotting of varying degrees.

Circular biopsy of the cervix

Circular biopsy is one of the types of cervical conization, which can be performed using a scalpel or using a radio wave knife. During a circular biopsy, a large area of ​​the cervix is ​​removed, including part of the cervical canal. This biopsy method is used both as a diagnosis and as a treatment for certain pathological conditions of the cervix. A circular biopsy also refers to an extended biopsy, since not only suspicious areas of tissue are taken for examination, but also neighboring tissues that may appear healthy.

A circular biopsy is performed under general anesthesia, spinal or epidural anesthesia in a hospital setting (in a hospital). You may have pain and bloody vaginal discharge for several weeks after the biopsy.

Endocervical curettage

Endocervical curettage differs significantly from the cervical biopsy methods listed above, but just like a biopsy, this analysis helps to identify malignant processes in the cervix.

Endocervical curettage is curettage of the cervical canal (not to be confused with uterine curettage), thanks to which it is possible to obtain cells from the cervical canal for research.

Local anesthesia is used to perform endocervical curettage.

How is a cervical biopsy done?

There are several different methods for performing a cervical biopsy, and depending on the method chosen, the doctor's actions may vary.

Ask your gynecologist how this procedure will work in your case.

If the biopsy is performed by a gynecologist in his office, this means that you will not be given general anesthesia, that is, you will remain conscious. To perform the biopsy, you will need to sit in the gynecologist's chair, as you would during a regular examination. In order to see the cervix, the doctor will insert a speculum into the vagina. A bright light will then be shined on your cervix to help you see it better. If necessary, the doctor will inject an anesthetic in the cervical area - this will help reduce pain during the biopsy. Suspicious areas of the cervix will then be removed and sent for histological examination under a microscope. The whole procedure will take no more than 25-30 minutes. You will be able to go home immediately after the biopsy.

If the biopsy is done in a hospital, you will most likely need to be hospitalized for 1-2 days. In this case, you need to ask what type of anesthesia you will receive: general anesthesia, spinal or epidural anesthesia. If you have general anesthesia, you will be asleep during the procedure; If you have a spinal or epidural anesthesia, you will remain conscious but will not feel the lower half of your body. The entire procedure, including anesthesia, can take from 40 minutes to 1.5 hours. After the biopsy, you will need to stay in the hospital for a few more hours, or until the next morning.

Cervical biopsy: does it hurt?

A cervical biopsy may seem painful, so in most cases, before taking material for examination, the gynecologist injects a painkiller into the cervix.

Some biopsy techniques can be so painful that they require general anesthesia, spinal or epidural anesthesia.

In any case, your doctor will do everything to make the procedure painless and comfortable for you.

What happens after a cervical biopsy?

Almost all women experience bleeding from the vagina after a biopsy. Depending on which biopsy method was used, the discharge may be more or less abundant and prolonged:

after targeted, conchotomous, radio wave or laser biopsy: light discharge, lasting 2-3 days;

after loop biopsy (electroexcision), conization of the cervix: discharge may be quite heavy (like bleeding during menstruation) for the first 5-7 days, and then spotting for several weeks.

If you experience spotting, use. You should not use tampons, douche, or have sex until the discharge stops completely.

You may also experience pain in the lower abdomen or deep inside the vagina after the biopsy. This is normal and the pain will go away soon.

Some women may have a fever after a cervical biopsy. An increase in temperature may be associated with stress, but may also indicate infectious complications. Contact your gynecologist if your body temperature is above 37.5C.

Is it possible to have sex after a cervical biopsy?

Complications of cervical biopsy

In rare cases, complications such as bleeding and infection may occur after a biopsy. See your doctor as soon as possible if:

you have heavy bleeding that is bright red or dark in color with blood clots

“period” after biopsy lasts more than 7 days in a row

bleeding is not profuse, but lasts more than 2-3 weeks

your body temperature has risen (37.5C ​​or higher)

you have vaginal discharge with an unpleasant odor

Consequences of cervical biopsy

Puncture, conchotomic, laser and radio wave biopsies, as a rule, do not leave any consequences.

After electroexcision (loop biopsy), as well as after conical biopsy (wedge-shaped and circular), scars (scars) may remain on the cervix. Some women with cervical scars may have difficulty conceiving or maintaining a pregnancy.

If you have had a cervical biopsy and are planning a pregnancy in the future, be sure to tell your gynecologist.

How to interpret the results of a cervical biopsy?

Only a specialist can adequately decipher the results of a cervical biopsy: a gynecologist or oncologist. Do not rush to interpret the results yourself, as some terms may unduly frighten you.

In this article, we'll look at the meaning of key terms you may see in your cervical biopsy results.

What are koilocytes?

Koilocytes are modified cervical cells that appear if a woman is infected with HPV. Normally, there should be no koilocytes, and their presence indicates an increased risk of developing dysplasia and cervical cancer. It is important to understand that the presence of koilocytes is not precancer or cancer. However, you need to pay special attention to your health and listen to your doctor's recommendations.

What is acanthosis, parakeratosis, hyperkeratosis, leukoplakia?

Acanthosis, parakeratosis, hyperkeatosis - all these processes in the cervix represent the replacement of normal cervical epithelium with keratinizing epithelium (like keratinizing epithelium of the skin).

These conditions are not yet precancer or cervical cancer, and yet, your gynecologist will advise removing these altered areas of the cervix.

What is cervical dysplasia?

What to do if the results of a cervical biopsy are bad?

First of all, don't worry. In most cases, unwanted changes in the cervix can be successfully treated. It can even be cured if detected in time.

Contact your gynecologist and, if necessary, consult an oncologist. Listen to the recommendations of your treating doctors and do not self-medicate.

“You need to get a biopsy” - many have heard this phrase from their attending physician. But why is it needed, what does this procedure provide and how is it carried out?

Concept

A biopsy is a diagnostic study that involves taking biomaterial from a suspicious area of ​​the body, for example, a lump, a tumor formation, a wound that does not heal for a long time, etc.

This technique is considered the most effective and reliable among all those used in the diagnosis of oncological pathologies.

Photo of breast biopsy

• Thanks to microscopic examination of the biopsy, it is possible to accurately determine the cytology of the tissue, which provides complete information about the disease, its degree, etc.
• The use of a biopsy makes it possible to identify the pathological process at its earliest stage, which helps to avoid many complications.
• In addition, this diagnosis allows you to determine the extent of the upcoming operation in cancer patients.

The main task of a biopsy is to determine the nature and nature of pathological tissue. For detailed diagnostics, biopsy examination is supplemented with water x-ray techniques, immunological analysis, endoscopy, etc.

Kinds

Biomaterial can be collected in different ways.

1. – a technique for obtaining a biopsy using a special thick needle (trephine).
2. Excision biopsy is a type of diagnosis in which an entire organ or tumor is removed during surgery. It is considered a large-scale type of biopsy.
3. puncture– This biopsy technique involves obtaining the necessary samples by puncture with a thin needle.
4. Incisional. Removal affects only a certain part of the organ or tumor and is carried out during a full-fledged surgical operation.
5. Stereotactic– a minimally invasive diagnostic method, the essence of which is to build a specialized access scheme to a specific suspicious area. Access coordinates are calculated based on a preliminary scan.
6. Brush biopsy– a variant of the diagnostic procedure using a catheter, inside of which a string with a brush is built in, collecting biopsy material. This method is also called brush method.
7. Fine needle aspiration biopsy– a minimally invasive method in which material is collected using a special syringe that sucks out biomaterial from tissues. The method is applicable only for cytological analysis, since only the cellular composition of the biopsy is determined.
8. Loop biopsy – a biopsy sample is taken by excision of pathological tissue. The required biomaterial is cut off with a special loop (electric or thermal).
9. Transthoracic biopsy is an invasive diagnostic method used to obtain biomaterial from the lungs. It is carried out through the chest using an open or puncture method. Manipulations are carried out under the supervision of a video thoracoscope or computed tomograph.
10. Liquid biopsy is the latest technology for identifying tumor markers in liquid biopsy, blood, lymph, etc.
11. Radio wave. The procedure is carried out using specialized equipment - the Surgitron apparatus. The technique is gentle and does not cause complications.
12. Open– this type of biopsy is carried out using open access to the tissues whose sample needs to be obtained.
13. Preskalennaya biopsy is a retroclavicular study in which a biopsy sample is taken from the supraclavicular lymph nodes and lipid tissues at the angle of the jugular and subclavian veins. The technique is used to identify pulmonary pathologies.

Why is a biopsy done?

A biopsy is indicated in cases where, after other diagnostic procedures, the results obtained are not sufficient to make an accurate diagnosis.

Typically, a biopsy is prescribed upon detection to determine the nature and type of tissue of the formation.

This diagnostic procedure is today successfully used to diagnose many pathological conditions, even non-oncological ones, since in addition to malignancy, the method allows one to determine the degree of spread and severity, stage of development, etc.

The main indication is to study the nature of the tumor, however, a biopsy is often prescribed to monitor the ongoing oncology treatment.

Today, a biopsy can be obtained from almost any area of ​​the body, and the biopsy procedure can perform not only a diagnostic, but also a therapeutic mission, when the pathological focus is removed in the process of obtaining biomaterial.

Contraindications

Despite all the usefulness and highly informative nature of the technique, biopsy has its contraindications:

• The presence of blood pathologies and problems associated with blood clotting;
• Intolerance to certain drugs;
• Chronic myocardial failure;
• If there are alternative non-invasive diagnostic options that have similar information content;
• If the patient refuses to undergo such a procedure in writing.

Material research methods

The resulting biomaterial or biopsy specimen is subjected to further examination using microscopic technologies. Typically, biological tissues are sent for cytological or histological diagnosis.

Histological

Sending a biopsy sample for histology involves conducting a microscopic examination of tissue sections, which are placed in a specialized solution, then in paraffin, after which staining and sections are carried out.

Staining is necessary so that cells and their areas are better distinguished during microscopic examination, on the basis of which the doctor draws up a conclusion. The patient receives results in 4-14 days.

Sometimes histological examination needs to be carried out urgently. Then the biomaterial is taken during the operation, the biopsy sample is frozen, and then sections are made and stained according to a similar scheme. The duration of such analysis is no more than 40 minutes.

Doctors have a fairly short period of time to determine the type of tumor and make decisions on the extent and methods of surgical treatment. Therefore, in such situations, urgent histology is practiced.

Cytological

If histology was based on the study of tissue sections, it involves a detailed study of cellular structures. A similar technique is used if it is not possible to obtain a piece of tissue.

Such diagnostics are carried out mainly to determine the nature of a particular formation - benign, malignant, inflammatory, reactive, precancerous, etc.

The resulting biopsy is used to make a smear on glass, and then conduct a microscopic examination.

Although cytological diagnosis is considered simpler and faster, histology is still more reliable and accurate.

Preparation

Before the biopsy, the patient must undergo laboratory testing of blood and urine for the presence of various types of infections and inflammatory processes. In addition, magnetic resonance, ultrasound, and x-ray diagnostics are performed.

The doctor studies the picture of the disease and finds out whether the patient is taking medications.

It is very important to tell your doctor about the presence of pathologies of the blood clotting system and allergies to medications. If the procedure is planned to be carried out under anesthesia, then you should not eat or drink liquid 8 hours before taking the biopsy sample.

How is a biopsy done in certain organs and tissues?

The biomaterial is collected using general or local anesthesia, so the procedure is usually not accompanied by painful sensations.

The patient is placed on a couch or operating table in the position required by the specialist. After which they begin the process of obtaining a biopsy sample. The total duration of the process is often several minutes, and with invasive methods it can reach half an hour.

In gynecology

The indication for biopsy in gynecological practice is the diagnosis of pathologies of the vagina, ovaries, and external organs of the reproductive system.

Such a diagnostic technique is decisive in detecting precancerous, background and malignant formations.

In gynecology they use:

• Incisional biopsy - when tissue is excised with a scalpel;
• Targeted biopsy - when all manipulations are controlled by extended hysteroscopy or colposcopy;
• Aspiration – when the biomaterial is obtained by aspiration;
• Laparoscopic biopsy - this method usually takes a biopsy sample from the ovaries.

Endometrial biopsy is performed using a pipette biopsy, which uses a special curette.

Intestines

A biopsy of the small and large intestines is performed in various ways:

• puncture;
• Petlev;
• Trepanation - when a biopsy is taken using a sharp hollow tube;
• Shchipkov;
• Incisional;
• Scarification - when the biopsy is scraped.

The specific choice of method is determined by the nature and location of the area being examined, but most often they resort to colonoscopy with biopsy.

Pancreas

Biopsy material from the pancreas is obtained in several ways: fine needle aspiration, laparoscopic, transduodental, intraoperative, etc.

Indications for a pancreatic biopsy are the need to determine morphological changes in pancreatic cells, if present, and to identify other pathological processes.

Muscles

If a doctor suspects that a patient has developed systemic connective tissue pathologies, which are usually accompanied by muscle damage, a biopsy examination of the muscle and muscle fascia will help determine the disease.

In addition, this procedure is performed if there is a suspicion of the development of periarteritis nodosa, dermatopolymyositis, eosinophilic ascites, etc. Such diagnostics are used using needles or in the open way.

Heart

Biopsy diagnosis of the myocardium helps to detect and confirm pathologies such as myocarditis, cardiomyopathy, ventricular arrhythmia of unknown etiology, as well as to identify processes of transplanted organ rejection.

According to statistics, a right ventricular biopsy is more often performed, with access to the organ through the right jugular vein, femoral or subclavian vein. All manipulations are controlled by fluoroscopy and ECG.

A catheter (bioptome) is inserted into a vein and guided to the desired area where a sample is to be obtained. On the bioptome, special tweezers open and bite off a small piece of tissue. To prevent thrombosis, a special medicine is pumped through the catheter during the procedure.

Bladder

Bladder biopsy in men and women is performed in two ways: cold and TUR biopsy.

The cold method involves transurethral cytoscopic penetration and biopsy sampling with special forceps. TUR biopsy involves removing the entire tumor down to healthy tissue. The purpose of such a biopsy is to remove all visible formations from the bladder walls and make an accurate diagnosis.

Blood

A bone marrow biopsy is performed in the case of malignant tumor pathologies of the blood such as.

Also, a biopsy examination of bone marrow tissue is indicated for iron deficiency, splenomegaly, thrombocytopenia and anemia.

Using a needle, the doctor removes a certain amount of red bone marrow and a small bone tissue sample. Sometimes the study is limited to obtaining only a bone tissue sample. The procedure is performed by aspiration or trepanobiopsy.

Eyes

Examination of eye tissue is necessary if there is a tumor of malignant origin. Such tumors are often found in children.

A biopsy helps to obtain a complete picture of the pathology and determine the extent of the tumor process. In the process of diagnosing retinoblastoma, aspiration biopsy using vacuum extraction is used.

Bone

A bone biopsy is performed to identify either infectious processes. Typically, such manipulations are performed percutaneously by puncture, with a thick or thin needle or surgically.

Oral cavity

An oral biopsy involves obtaining biopsies from the larynx, tonsils, salivary glands, throat and gums. Such diagnostics are prescribed when pathological formations of the jaw bones are detected or to determine salivary glandular pathologies, etc.

The procedure is usually performed by a facial surgeon. He uses a scalpel to remove part and the entire tumor. The whole procedure takes about a quarter of an hour. Pain is observed when an anesthetic is injected, but there is no pain when a biopsy is taken.

Analysis results

The results of biopsy diagnostics are considered normal if the patient does not have cellular changes in the tissues being examined.

Consequences

The most common consequence of such a diagnosis is rapid bleeding and pain at the site of biopsy sampling.

About a third of patients experience moderate to mild pain after a biopsy.

Serious complications after a biopsy usually do not occur, although in rare cases, fatal consequences of the biopsy occur (1 in 10,000 cases).

Post-procedure care

For severe pain, analgesics can be used. Caring for the puncture site or suture (depending on the type of procedure) may vary slightly, but you can remove the bandage only one day after the biopsy, at which time you can take a shower.