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The perfection of cytological techniques in the detection of early carcinoma of the cervix has necessarily required the widespread use of cervical biopsy for confirmation. The frequent small size of the lesions, their clinically inconspicuous appearance, involvement of the endocervix, and the ease with which they may be destroyed, lost, or rendered undiagnosable by the usual techniques of biopsy have indicated the development of new instruments and methods.
When carcinoma is strongly suggested by cytology but the cervix is clinically free of an obvious lesion, the cold cone is recommended to confirm the diagnosis and define its extent and aggressiveness. However, especially in pregnancy, often reports are given of "cells suspicious of malignancy" or "inconclusive findings," their frequency depending on the competence, self discipline, and philosophy of the cytologist. Here, a less rigorous procedure is permitted, avoiding the disadvantages of hospitalization and the risks of hemorrhage and stenosis. Toward this
Chester MH, Frank JH. NEW INSTRUMENT FOR BIOPSY OF THE CERVIX AND ENDOCERVIX. JAMA. 1959;169(10):1062–1063. doi:10.1001/jama.1959.73000270004010a
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