Dear OncoLink "Ask the Experts,"
What is cervical conization? How serious is it when the doctor recommends conization? How is conization performed? Why do the doctors do this?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
Conization, or cone biopsy, of the cervix is a technique to remove a cone shaped piece of tissue from the cervix. This can be performed as a small day surgery procedure in the operating room under anesthesia, or sometimes a physician may opt to perform a LEEP (loop electrocautery excision procedure) in the office under local anesthesia.
Cone biopsies are performed to diagnose or to treat abnormal cells of the cervix. Usually, this process starts with an abnormal Pap test. If the Pap abnormality warrants further investigation, your gynecologist will perform office colposcopic examination with endocervical curettage and directed biopsies of any abnormal areas on your cervix. A cone biopsy may be performed to help clarify a diagnosis and to preclude invasive cancer in the following situations: an inadequate colposcopic examination, high grade dysplasia on the endocervical curettage, adenocarcinoma in situ, a significant discrepancy between pap smear and biopsy findings, or a colposcopic examination concerning for invasive cancer (even if biopsies show only carcinoma in situ). Once adequate diagnosis has been made, dysplastic lesions of the cervix can be treated by cone biopsy as well.
If a conization has been recommended, this does not necessarily mean that you have cervical cancer. Cone biopsy may be adequate treatment for precancerous lesions. You should certainly discuss with your physician the specific reason he or she is recommending you undergo this procedure.