Vulvar biopsy: Punch biopsy or cervical forceps biopsy?

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.