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Vulvar biopsy: Punch biopsy or cervical forceps biopsy?
Anthony Tuil1, Christine Bergeron2, Justine Varinot Lucet3
1Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospital, 26 rue Lazare Carnot, Paris 75013, France.
Journal of Gynecology Obstetrics and Human Reproduction
|September 14, 2023
Summary
Punch biopsy (PB) and cervical forceps biopsy (CFB) show similar diagnostic accuracy for vulvar lesions. Both methods have low rates of non-contributory biopsies and underestimation of severe conditions, ensuring reliable initial diagnosis.
Area of Science:
- Gynecologic Oncology
- Dermatopathology
- Surgical Pathology
Background:
- Accurate diagnosis of vulvar lesions is crucial for appropriate management.
- Choosing the optimal biopsy technique is essential for diagnostic yield and patient care.
Purpose of the Study:
- To compare the diagnostic performance of punch biopsy (PB) versus cervical forceps biopsy (CFB) for vulvar lesions.
- To evaluate the rate of underestimation of more severe lesions following vulvar biopsy prior to excision.
Main Methods:
- A retrospective, descriptive, and comparative study involving 179 vulvar biopsies (100 PB, 79 CFB) across three centers between 2017-2022.
- Statistical analysis included Mann-Whitney, Pearson's chi-squared, and Fisher's exact tests with a significance level of 5%.
Main Results:
- No significant difference was found in the rate of non-contributory biopsies between PB and CFB groups (p=1).
- In a subset of 68 patients undergoing vulvectomy post-biopsy, 97% showed good correlation between biopsy and excision specimen pathology, indicating low underestimation rates.
Conclusions:
- Both punch biopsy and cervical forceps biopsy demonstrate comparable diagnostic performance for vulvar lesions.
- These techniques are associated with similarly low rates of non-contributory samples and underestimation of invasive disease.
