A 40-year-old woman is found on colposcopy-directed biopsy to have squamous cell carcinoma invading 6 mm in depth and 8 mm in horizontal spread, with no parametrial involvement and no lymphovascular space invasion. According to FIGO 2018 staging, she is classified as:
- A Stage IA1
- B Stage IB1 ✓
- C Stage IA2
- D Stage IB2
Correct answer: B. Stage IB1
Explanation
FIGO 2018 cervical cancer staging: Stage IA = invasive carcinoma diagnosed microscopically, invasion depth ≤5 mm; IA1 = depth ≤3 mm; IA2 = depth 3.1–5 mm. Stage IB = clinically visible lesion OR depth >5 mm; IB1 = tumor ≤2 cm; IB2 = tumor >2 cm and ≤4 cm. With invasion depth of 6 mm (exceeding the 5 mm IA limit), this case is Stage IB. The 8 mm horizontal spread and the 6 mm depth place it as Stage IB1 (≤2 cm). FIGO 2018 also allows imaging and pathological nodal assessment to upstage.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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