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Also known as a cone biopsy, conization is a common treatment option for cervical dysplasia. This precancerous condition is characterized by abnormal cellular changes on the surface of the cervix, which connects the lower uterus to the upper vagina.

In many cases, cervical dysplasia is detected in a cervical cancer screening test, such as a routine Pap smear. Depending on how abnormal the cells appear (in relation to normal cells) when viewed under a microscope, cervical dysplasia can range from mild to severe.

When does cervical dysplasia require treatment?

Dysplasia found in a Pap test is known as a squamous intraepithelial lesion (SIL), which may be classified as:

  • Low-grade (LSIL)
  • High-grade (HSIL)
  • Possibly cancerous
  • Atypical glandular cells (AGC)
  • Atypical squamous cells (ASC)

To follow up on an abnormal Pap test result, a physician may perform a colposcopy to closely examine the cervix and biopsy a small sample of suspicious tissue. Dysplasia found in a biopsy is known as cervical intraepithelial neoplasia (CIN), which may be classified as:

  • CIN I - Mild dysplasia
  • CIN II - Moderate to marked dysplasia
  • CIN III - Severe dysplasia to carcinoma in situ

Mild cases of cervical dysplasia, such as LSIL and CIN 1, may resolve on their own. However, if left untreated, moderate to severe cases can potentially progress into cervical cancer. Conization may be performed to remove and further examine abnormal or precancerous cells from the cervix. It is also a treatment option for early-stage cervical cancer.

What does conization (cone biopsy) involve?

Essentially an intensified biopsy of the cervix, conization is an outpatient procedure that involves removing a large cone-shaped piece of abnormal tissue along with a small margin of surrounding healthy tissue. The physician will form the cone by removing part of the cervix near the vagina and part of the pathway from the uterus to the vagina (endocervical canal), helping to ensure that deep layers of tissue are sampled.

Typically, a cone biopsy is performed under general anesthesia, although some patients elect local anesthesia, such as a nerve block. Exclusive of any pre- and post-operative care, the entire procedure takes approximately 15 minutes. Afterward, an area of normal tissue remains in the cervix.

The tissue removed during conization is sent to a lab for microscopic evaluation by a pathologist, who can determine whether the cells are normal, precancerous or cancerous. If precancerous or cancerous cells are found, the pathologist will also determine whether the margins are clear or if further treatment is needed. 

Benefit from world-class care at Moffitt Cancer Center

If you have received an abnormal Pap test result, you can feel confident turning to the multispecialty team in the gynecological clinic at Moffitt for an accurate diagnosis or second opinion. Moffitt is a recognized leader in detecting and treating all forms of gynecological cancer, and we offer our patients convenient access to the latest diagnostic techniques, including conization, as well as a wide variety of advanced treatment options in a single location.

You do not need a referral to meet with an expert at Moffitt. Request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online.