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Cancer: Cervical & Ovarian Message Board

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I was reading on another thread that there was a difference between these 3 items, but I'm not really clear on the differences.

I know the ECC is a sort of pap smear in the cervical canal. I think there are two different tools the doctor can use to do an ECC.

I know the different cone biopsies include LEEP/Lletz and cold knife cone biopsies. Those involve the doctor removing tissue deep in the cervical canal and a wider swath of cervix at the bottom.

But how do endocervical samplings or biopsies differ from those? Are these types of biopsies the pinch or punch biopsies that a doctor can do to the exocervix while doing the colpo?

I hope this isn't an abundantly clear answer and I'm just missing the differences.

Thanks ya'll!
Hi Pickle --

I'm sure someone will step in to correct me if I'm wrong, but I believe an ECC (endocervical currettage (sp??) is also an actual tissue sample rather than just a scraping like you would get for a pap -- hence the term "curettage" attached to the name. Also, I believe that when they do an ECC, they are only sampling one portion/quadrant/area of the cervical canal, and not the entire 360 degrees of the canal. I know personally that my ECC removed a 1cm by 1cm by less than 1mm less piece of tissue, which would confirm my understanding of an ECC being an actual removal of tissue. I also know that my ECC did NOT diagnose my AIS or cc, although my punch biopsies on the outer cervix did -- so while it is one of the best methods for determining what's going on, obviously it's not foolproof, and my results also seem to support that they only sample one area of the canal, and not the whole thing. Also, there may very well be different tools they use to accomplish this, but I certainly didn't look when my procedure was being performed!!

As for the LEEP/LEETZ and CKC, the depth of the procedure depends on the doctor performing it, and I *believe* that despite the term "cone" in the CKC and the belief that it goes deeper into the cervical canal, the tissue that is actually taken is only very slightly cone shaped. In my particular case, my CKC was 2cm in diameter across the bottom, and 1.6cm in diameter across the top -- so while technically the topmost portion of my sample was more narrow and also deeper than where it started on the outermost portion of the cervix, I'd hardly call a 4mm difference an actual cone (and I'd hardly consider 1.6cm a "pointy" or "cone-like" piece of tissue). If you do an image search for cone biopsy tissue samples, you'll get a better idea of what they actually look like, and from what I've seen, none of them even mildly resemble a cone. Most studies/reports will say that a CKC samples deeper into the canal, and I think that is because in general docs go deeper, i.e. take a larger amount of cervix than they do when doing a LEEP/LEETZ -- but again, that depends on the doc. I've posted elsewhere that my CKC was only 6mm deep, and I know several others who have posted about having had LEEPs of 1cm or more.

I'm not sure if docs do a pinch/punch biopsy of the cervical canal similar to what they do during a colpo on the ectocervix, and/or if that is sometimes referred to as an ECC -- but I think a true ECC takes more than just the small amount of material taken in a pinch/punch biopsy, which is usually only a 1mm by 1mm sample.

Feel free to correct me if I'm in correct in any of this, but that's my understanding of the procedures.

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