A girl friend of mine had to have a cervical biopsy today because a routine pap smear a few weeks ago returned a result of some “abnormal cells.” She is worried, of course, but adding to her concern is that the doctor took three samples during the biopsy. She thinks that means her situation is bad. Without knowing a thing about what I’m talking about, I told her it was probably perfectly normal and that multiple samples were needed to assure a proper diagnosis.
Has anyone ever had this procedure and does it sound normal? I told her to call the doctor’s office and ask, but I don’t know if she has done it. I’d like to ease her mind some if it is indeed a routine part of this type of biopsy.
I also think her doctor should have explained the procedure to her in advance, but I wasn’t there and what do I know?
Not my area, but I do know that pap smears give a pretty high rate of false positives, which is normal for a screening test, and why they follow it up with further testing.
It is a general principle in medicine and surgery that multiple biopsies increase the ‘diagnostic yield’. Indeed, when performing biopsies it is very easy to miss the area of interest or to find out too late (after the biopsy slides are back) that the site sampled was nothing but dead or inflamed tissue, or even blood clot.
Performing multiple biopsies also implicitly takes into account the fact that diseases (e.g. cancer, blood vessel inflammation, etc.) seldom grow/encompass in a perfectly radial, spherical, planar, etc., way. There may be intervening or intertwining areas of normal tissue.
The lesion itself may also be heterogeneous with key diagnostic features not present in every sample.
In other words, that multiple biopsies were done should be taken as a sign that the doctor was doing things properly and conscientiously and not that “things looked bad”.
That said, perhaps Jackmannii can set us straight regarding cervical biopsies in particular.
There are a lot of reasons for taking three samples, but the first one is that if someone makes a mistake with one of them, they don’t have to call her back and make her go through the procedure again. Another is that if the first one is positive, they want to run a second, and if that one is negative, they want to run a third. They aren’t going to give her bad news until it’s a “two out of three” situation. If she has just one positive, they will probably tell her the chances are it’s a lab error, but she should have her next pap smear in x months instead of x+y months, where x+y is the standard interval for her age.
It’s really nothing to worry about. When they take blood, they always take a bunch of samples, and one is just for typing, and other general sorts of testing.