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Q. Can cervical dysplasia come back after a cone biopsy?

Answered by
Dr. Deepali Raina
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jun 23, 2020

I had a cone biopsy done a couple of years back due to a dysplasia caused by HPV. The papanicolau test last year showed there was no injury. I just did a papanicolau this week and the result says “Moderate dysplasia suggesive, Class IIIA”.

The doctor told me have a biopsy done. I was told that it was very unlikely that the dysplasia came back after the cone biopsy. How should I proceed?

Dr. Deepali Raina

Obstetrics And Gynaecology
# Hi
This report is a matter of concern. there is definitely a need for another cone. you have to note that another cone is very difficult to do too and may even be unsuccessful. Also when you go for another cone check the margins of the cone. if the margins of the cone are still positive then removal of cervix known as trachelectomy will be the only option for you.
Infact since your dysplasia has come back after a cone there is a possibility that it is already an invasive cancer. I recommend that you do a revision of the biopsy report by some other pathologist also just to be doubly sure. I don't want to alarm you but informing you of all the possibilities is my responsibility too

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