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Risks and reasons for repeat colposcopy and cone biopsy

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Christina S. Chu, MD
Last Modified: April 14, 2002

Dear OncoLink "Ask The Experts,"
I have had an abnormal Pap smear, a colposcopy and a cone biopsy. The cone biopsy showed CIN III. I understand from my doctor that the biopsy did not remove all of the cells. I am currently awaiting repeat colposcopy. What will this show, if anything, and what may they do if all the abnormal area was not removed? Am I right to believe the more they remove, the greater the risk of miscarriage in pregnancy? But most importantly what will they do if it was not all removed? It is difficult to get info in the UK.

Thanks for your time.  

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

If your repeat colposcopy in continues to show cells with severe dysplasia, the recommended treatment is usually a repeat cone biopsy. While it may be true that the more tissue that is removed from your cervix, the more chance exists for you to experience infertility or a problem in future pregnancies, the risk is low.

Please understand, that after a cone biopsy (even sometimes when the margins of the removed tissue show that abnormal cells may remain on the cervix) the abnormal cells may go away, or any remaining dysplasia may be mild. I would recommend that you discuss your specific concerns with your health care provider.