Non-diagnostic results of endocervical curettage (ECC)
Dear OncoLink "Ask The Experts,"
I recently had a colposcopy for a CIN abnormal pap. I was told I had 3 suspicious lesions. An endocervical curettage (ECC) was also done. The biopsy report states the (ECC) was "non-diagnostic" as well as one biopsy. What exactly does "non-diagnostic" mean? My family physician did this procedure. He recommended cryotherapy. I was told cryotherapy was not a very reliable treatment since the depth could not be well controlled and no sample exists for testing. Should I see a specialist to make sure?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
"Non-diagnostic" usually means that the amount of tissue obtained was too small to make an accurate diagnosis. While cryotherapy and loop electrocautery excision procedure (LEEP) are both commonly practiced therapy for CIN II, I believe that you are right to be concerned about the non-diagnostic biopsies, especially the ECC. The standard recommendation at this point would be to have a repeat ECC before undergoing any procedure on the cervix. This is because if there is a more serious abnormality on the ECC, a LEEP or cone biopsy may be required (in other words, cryotherapy might not be the appropriate treatment). Though it is a commonly used treatment, in our practice, we rarely perform cryotherapy for the very reasons that you mentioned. If you are uncomfortable with your current physician, I would suggest you see a gynecologist who is experienced in colposcopy and the treatment of CIN disease of the cervix.
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