Cervical dysplasia and cervical cancer Quiz: Ace Your Exams
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A 32-year-old nulligravid woman presents for a colposcopy exam after routine screening came back with atypical squamous cells, cannot exclude high-grade (ASC-H) and positive high-risk human papillomavirus (HPV). The patient reports that she and her partner are planning to attempt conception next year, and she is concerned about the impact of any procedures on her cervix. After patient-centered counseling, she consents to the procedures today. She is healthy and her only medication is a prenatal vitamin. She does not use tobacco, alcohol, or other recreational substances. Family history is notable for a hysterectomy in her mother due to endometrial cancer at age 60. Vital signs are normal, and a urine pregnancy test is negative. On colposcopy exam, acetic acid is applied to the cervix and abnormalities are noted surrounding the cervical os. Representative biopsies are taken and return as cervical intraepithelial neoplasia (CIN) 3. Which of the following is the most appropriate next step in management for this patient given her fertility desires?
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