Spiral brush cervical biopsy experience in a community clinic

P. Sweet III, J. Chen, J.H. Schultz

Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA. phsweet@ucsd.edu

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• Gynecology

OBJECTIVE: This article seeks to demonstrate the experience of implementing the spiral brush in several community clinic locales. Before the introduction of the spiral brush cervical biopsy in 2002 there were few alternatives to colposcopy directed punch biopsy when evaluating and managing abnormal dysplastic Papanicolaou (pap) smear or a visually abnormal cervix. Subsequent investigations validated the spiral brush usage but there are limited reports for its implementation in primary care colposcopy.

PATIENTS AND METHODS: Over a two year period (2004-2006) patients with internal referrals for colposcopy received the spiral brush cervical biopsy. Those that resulted in the diagnoses of high grade squamous intraepithelial lesion (HSIL) diagnoses (CIN2-3) were compared to the final pathology diagnosis from the loop excision specimen.

RESULTS: 15 cases of HSIL were identified with subsequent loop excision. Comparison of the pathology diagnosis from the loop excision and the spiral brush biopsy resulted in 13.3% (n=2) of cases differing. In both cases, low grade squamous intraepithelial lesion (LSIL) diagnoses (CIN1) were found whereas the remainder had the same diagnosis of HSIL.

CONCLUSIONS: These results showed acceptable rates of concordance with traditional pathology specimens which supports the use of this Food and Drug Administration (FDA) approved device within a primary care setting.

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