What it is

• ➤ A cervical biopsy is a diagnostic procedure where a doctor removes a small piece of tissue from the cervix (the lower part of the uterus) for examination under a microscope.
• ✦ The aim is to confirm whether abnormal cells—detected during Pap smear, HPV testing, or colposcopy—are precancerous, cancerous, or benign.
• ➟ Different types of cervical biopsies:
  • ▪ Punch biopsy: Small tissue samples are taken with a punch instrument during colposcopy.
  • ▪ Endocervical curettage (ECC): Scrapes cells from the cervical canal.
  • ▪ Cone biopsy (conization): Removes a larger cone-shaped portion of cervical tissue, often done if high-grade lesions are suspected.
• Important: Cervical biopsy is a diagnostic test, not a treatment, but it provides definitive answers about abnormal cervical findings.

Why it’s done

• ➤ Main purpose: To determine if abnormal cervical cells are precancerous or cancerous.
• ✦ Indications include:
  • ▪ Abnormal Pap smear (ASC-US, LSIL, HSIL).
  • ▪ Positive high-risk HPV test.
  • ▪ Suspicious cervical appearance during colposcopy.
  • ▪ Unexplained vaginal bleeding.
• ➟ Benefits:
  • ✅ Provides a clear diagnosis, allowing timely treatment.
  • ✅ Differentiates between harmless changes and true precancer/cancer.
• ⟶ Limitations:
  • ▪ Invasive compared to Pap/HPV test.
  • ▪ May cause mild bleeding or discomfort.
• Bold takeaway: Without biopsy, doctors cannot confirm if abnormal cells are truly dangerous—it is a key step for cancer prevention.

Alternatives

• ➤ Repeat Pap or HPV test: For minor abnormalities, but less definitive.
• ✦ Colposcopy without biopsy: Can suggest abnormal areas but cannot confirm diagnosis.
• ➟ Imaging (ultrasound/MRI): May help for advanced cases but not a replacement for biopsy.
• Important: No test fully replaces a biopsy for confirming cervical cancer.

Preparation

• ➤ Timing: Best scheduled when not menstruating.
• ✦ Avoid for 24–48 hours before biopsy:
  • ▪ Sexual intercourse
  • ▪ Vaginal creams or medicines
  • ▪ Douching
  • ▪ Tampons
• ➟ Tell your doctor if you:
  • ▪ Are pregnant (some biopsies are avoided).
  • ▪ Take blood thinners (risk of bleeding).
  • ▪ Have clotting or immune disorders.
• → Bring: Prior Pap/HPV results, medical records, ID or insurance card.
• Important: Eat lightly before the procedure unless sedation is planned.

How it’s done

• ➤ Step 1 – Colposcopy setup: You lie on an exam table, a speculum is inserted to visualize the cervix.
• ✦ Step 2 – Application of solutions:
  • ▪ Vinegar solution turns abnormal cells white.
  • ▪ Lugol’s iodine helps highlight suspicious areas.
• ➟ Step 3 – Biopsy collection:
  • ▪ Punch biopsy: tiny samples removed.
  • ▪ ECC: cells scraped from inside the canal.
  • ▪ Cone biopsy: a larger cone-shaped sample removed under anesthesia.
• ➤ Step 4 – Hemostasis: The doctor may use chemical solution or cautery to control bleeding.
• → Duration: 10–20 minutes for small biopsies, longer for cone biopsy.
• Important: Local anesthesia may be used for comfort; cone biopsy often requires regional or general anesthesia.

Recovery

• ➤ After punch biopsy or ECC:
  • ▪ Mild cramping and spotting for a few days.
  • ▪ Avoid tampons, intercourse, and douching for 5–7 days.
• ✦ After cone biopsy:
  • ▪ Heavier bleeding possible for up to 2 weeks.
  • ▪ Recovery may take 2–4 weeks.
  • ▪ Strict restrictions on heavy exercise and intercourse.
• ➟ Results:
  • ▪ Normal → resume routine screening.
  • ▪ Precancer (CIN) → treatment options like cryotherapy, laser, or LEEP.
  • ▪ Cancer → staging and oncology care.
• ⟶ Seek urgent care if:
  • ➤ Heavy bleeding (soaking pads).
  • ➤ Severe pain or fever.
  • ➤ Foul-smelling discharge.
• Important: Follow-up visits are essential to plan treatment and prevent progression.

Treatment option in Korea

• ➤ Where available:
  • ▪ University hospitals in Seoul, Busan, Incheon, Daegu, Gwangju.
  • ▪ Specialized women’s health centers with gynecologic oncology units.
• ✦ Why Korea:
  • ▪ Advanced diagnostic labs for rapid and accurate pathology.
  • ▪ Expert OB-GYNs with high procedure volumes.
  • ▪ International clinics with English-speaking coordinators.
• ➟ If biopsy is abnormal:
  • ▪ Cryotherapy or laser → destroys abnormal tissue.
  • ▪ LEEP (Loop Electrosurgical Excision Procedure) → removes abnormal areas precisely.
  • ▪ Cone biopsy/excision → deeper tissue removal if high-grade precancer.
  • ▪ Comprehensive cancer care if invasive cancer is diagnosed.
• ⟶ For international patients:
  • ▪ Share prior test results in advance.
  • ▪ Expect same-day biopsy with results in a few days.
  • ▪ Request reports in English for home country doctors.
• Important: Korea’s medical system emphasizes efficiency + accuracy, making it suitable for both residents and international patients seeking reliable cervical care.