RESUMO
INTRODUCTION: To investigate the indications for performing a second large loop excision of the transformation zone (LLETZ) biopsy and to compare the associated colposcopic and pathological findings and treatment morbidity compared with 1 LLETZ. METHODS: This is a case-control study that reviewed case notes and histology reports on women who had undergone 1 LLETZ biopsy (control group) and women who had undergone 2 biopsies (index group). A comparison of referral cytology, colposcopic findings, and pathological and clinical outcomes was performed. RESULTS: Of the women who went on to have 2 LLETZ biopsies, 88% had histologically proven high-grade cervical intraepithelial neoplasia (CIN) or invasion on their first biopsy. A significantly greater proportion of high-grade cytologic and histologic diagnoses were associated with the first LLETZ compared with the second LLETZ biopsy, 76.5% and 69.1% versus 39.5% and 30.9%, respectively. A significantly greater proportion of women in the control group were referred with low-grade cytology (28.0%) and were diagnosed with human papillomavirus/low-grade CIN on histology (31.7%) compared with the first cytologic and LLETZ results in the index group, 9.9% and 8.6%, respectively. Complications were low in both groups; the immediate complication rate was 4% after the first LLETZ compared with 1% after the second LLETZ. CONCLUSIONS: Most second LLETZ biopsies are performed in women with a history of biopsy-proven high-grade CIN and are not associated with an increased risk of immediate complications.
Assuntos
Biópsia/normas , Colo do Útero/cirurgia , Infecções por Papillomavirus/cirurgia , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Biópsia/métodos , Estudos de Casos e Controles , Colo do Útero/patologia , Colposcopia , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/patologia , Resultado do Tratamento , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/patologiaRESUMO
Ovarian cancer is difficult to diagnose and to manage. Early detection and successful treatment continue to challenge health care professionals, although over the past 20 years there have been modest improvements in overall outcomes. The charity WellBeing of Women is running a campaign called 'Breaking the Silence' to focus on the issue of ovarian cancer.