Abnormal cervical biopsy results

A cervical biopsy removes tissues or cells from the cervix. The tissue sample is examined under a microscope to look for changes or abnormalities such as cancer. If there are no abnormal cells, the result is reported as normal. An abnormal cervical biopsy means that there have been some changes to the cells in the cervix.

Abnormal cells in the cervix may be described in different ways using different terms. Most often abnormal cell changes in the cervix are described using the Bethesda reporting system, which gives information about how different the cells look from normal cells. The Bethesda reporting system includes the terms low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS). Other reporting systems refer to cervical intraepithelial neoplasia (CIN) and cervical dysplasia.

Dysplasia is a way to describe abnormal cell changes. It means that the cells are different from normal cells in size, shape and organization within tissue.

Dysplasia is described based on how much the abnormal cells look like normal cells:

• Mild dysplasia means the cells look slightly different from normal cells.
• Moderate dysplasia means the cells look quite different from normal cells.
• Severe dysplasia means the cells look very different from normal cells.

Cervical intraepithelial neoplasia (CIN) is another way to describe abnormal changes to squamous cells in the cervix. Neoplasia means an abnormal and uncontrolled growth of cells.

CIN is graded on a scale of 1 to 3 based on how much of the cervical lining has abnormal cells:

• CIN 1 means one-third of the thickness of the cervical lining has abnormal cells. It is also called mild dysplasia.
• CIN 2 means two-thirds of the thickness of the cervical lining has abnormal cells. It is also called moderate dysplasia.
• CIN 3 means the full thickness of the cervical lining has abnormal cells. It describes both severe dysplasia and carcinoma in situ (a very early stage of cancer in which tumour cells have not yet invaded surrounding tissues).

Squamous intraepithelial lesion (SIL) is the newest way of describing abnormal changes to the squamous cells in the cervix. SIL is described as low grade or high grade.

• Low-grade SIL (LSIL) is also described as mild dysplasia or CIN1. LSIL affects the lower part of the cervical lining. LSIL doesn't usually need treatment, and can go away on it's own.
• High-grade SIL (HSIL) is also described as moderate or severe dysplasia, CIN2 or CIN3, or carcinoma in situ. HSIL affects most of the cervical lining. HSIL has a higher chance of turning into cervical cancer in comparison to LSIL.

Adenocarcinoma in situ (AIS) describes cancer cells found in the glandular tissue of the endocervix. The cancer hasn’t spread into the deeper tissues of the cervix or surrounding tissue.

Follow-up and treatment options for an abnormal cervical biopsy can vary. Depending on how severe they are, some changes or abnormalities may not need to be treated. Some abnormal cells change back to normal on their own. Other abnormal cells or precancerous changes to cells may develop into cancer if they aren’t treated.

If you have abnormal cervical biopsy results, you may have one or more of the following procedures for follow-up or treatment:

• a pap test
• a human papillomavirus (HPV) test
• a colposcopy
• a biopsy
• an endocervical curettage
• cryosurgery
• laser surgery
• a cone biopsy
• a loop electrosurgical excision procedure (LEEP)

If you were diagnosed with LSIL while pregnant, you may not need a colposcopy or treatment until after you have had your baby.

If you were diagnosed with HSIL while pregnant, you will likely have a colposcopy or treatment 8 to 12 weeks after you have had your baby. But some people with HSIL will need to have a colposcopy, a Pap test or another biopsy during pregnancy. A cone biopsy is not usually done during pregnancy because there is a small risk of bleeding.