Biopsy results, need your experiences please - Cancer: Breast Message Board

phaedrus · 03-16-2005, 07:14 PM

Hi everyone,
I got my biopsy results today. Severe dysplasia (plus lesion- high grade I think) was confirmed. The indication is that it hasn't progressed through the membrane, though he said this will be confirmed with the LEEP (May 17th). He said the LEEP has a 97 % chance of removing all the cells (thus "curing" the condition, I assume), and if not, the LEEP is done again. I don't know what happens if they find the membrane has been crossed.

To anyone who has been diagnosed with cervical cancer: Is it something that is detected right away from the biopsy/colposcopy? Can I stop worrying completely now? Everyone keeps saying that if it was bad, they would have detected it by now. But I thought that until they do the LEEP, they can't confirm anything, but the tests so far can indicate the likelyhood of cancer.
I mean, it can't be advanced cervical cancer without them knowing by now surely?
My pelvic ultrasound showed "nothing in particular"- whatever that means. So my husband and I were pretty pleased that so far it has only been labelled as dysplasia and commented on the fact that this is good news. The doctor replied defensively "compared to what?". I keep getting mixed messages. I don't know whether to be relieved or not.
And apparently I don't get the option of being out for the procedure. He said I can drive myself there and back and it will take 5 minutes. Is this true?
Has anyone had leep results come back worse than expected?
And what is the difference between a laser and a leep?
Thanks everyone...

ElenaK · 03-16-2005, 07:43 PM

Hi phaedrus,

My dr told me that they can tell from the colpo biopsy results if the abnormal cells have spread past the base membrane. He explained that the pathologist takes each piece of tissue (yuck!

) and makes a vertical cut, looking for the extent of dysplasia. Roughly, if 1/3 of the epithelium is taken up by abnormal cells, it is CIN1; if 2/3, then CIN2; if 3/3 are dysplastic, then it is CIN3, i.e. severe (high grade) dysplasia. If the dysplasia has proceeded past the base membrane, then it is invasive cancer. (But even in this case there are grades according to how many millimeters the cells have spread past the membrane, so nothing is decided yet!!!)

However, do not freak out over CIN numbers. As I learned on this site, the pathologist will give you a CIN3 "verdict" even if s/he sees only a few CIN3 cells. My dr has confirmed this. They always go by the highest grade cells, no matter how few they are. Your post-LEEP biopsy could come back as CIN2 for all you know!

I hope you can find the strength to relax and take care of yourself until the LEEP. From what I have read and the dr tells me, they should have been able to tell from the colpo biopsies if it was cancer, so if they are saying just dysplasia, chances are this is all it is.

Hugs and best, best wishes.

13utterfly · 03-16-2005, 10:24 PM

Hi Phaedrus,

I have a CINIII lesion and I am scheduled for a LEEP on the 24th of March. I am being put out for this procedure. I received two opinions before making my decision one doctor said no you don't need to be out and the other said I only do LEEPs if the patient is out.

For a LEEP you are put under just a little amount of anesthesia and you breathe on your own. There is a posting on this message board titled something to the effect of "awake or asleep for a LEEP" I would read these postings and if you feel that you want to be alseep look for a different doctor. Are you seeing a regular gynecologist or a gynecological oncologist?

I got two opinions from gynecological oncologists you may want to check in to seeing one of those if you haven't already. Make sure you are really comfortable with your doctor. One of the doctors I saw he acted as if the procedure was nothing and wasn't too concerned with me, my feelings, and my questions. I didn't choose to have the procedure done with him. The other doctor identified with my concerns and felt free to answer all of my questions and I have actually called him and asked even more questions. Maybe you want to drive yourself, but maybe it's important that your husband is there with you too. From what you write it doesn't sound as if your doctor is really getting you the informaiton that you and your husband need to feel confident in him the procedure etc. You really want to click well with your doctor. After the LEEP there is follow up visits etc.

Good Luck! Hope I could help.

lobo1977 · 03-16-2005, 11:43 PM

I would strongly suggest a gyn/onc. They are more trained and specialize in these procedures. I saw a HUGE difference and felt much more comfy when I switched.

I had a CIN3 on the colpo, but a CIN2 after my leep. The line between numbers is VERY thin...I think I've only heard one women say she got a WORSE diagnosis after the leep - most people it matches or is a bit better. Even if it did end up a bit stage 1 cancer, the line is so thin - and the leep often cures early stages. I would not worry! I dont think its possible to have advanced cancer but only get a CIN3 from the colpo, it cant be that 'off' -- even w/ a little margin of error.

While its 'cured' for the moment, it can come back , so we need to monitor closely. I'm going every 3 months from now on... not taking any chances.

That 'compared to what' comment is obnoxious. I cant tolerate anyone saying things like that! At ANY stage, this is difficult. Yes, it could always be worse, can sometimes be better, but its GREAT To look at it as "it could be worse" thats a wonderful outlook and your Dr should commend you - its not like you are thinking you're ok and telling him you dont want treatment! When I was in the hospital I saw all these REALLY sick people and actually felt lucky that I was just having a leep!

Most times I dont see how you can be denied the option of being out? Last time I checked we are the patients. Unless it is a very large area of abnormal cells, and they are doing a lot of areas (aka- alonger, more delicate/detailed leep) I think the patient needs to decide this. Did you find out how many areas of abnormalities there are, and how much area of the cervix it covers?

To answer the laser question - (I just had a laser and leep together 2 weeks ago) it is good for larger abnormal areas that you wouldnt want to leep b/c too much would be 'scooped' out. Its a new/advanced machine that is less invasive, less scarring, less issues /w your cervix later, and is very precise. Only gyn/onc really are trained in laser. You would want a leep too, for the center area/worst parts, so they can take parts to biopsy. The two down sides of laser are that its EXPENSIVE - and, you can't take parts to biopsy (For laser ablation) because the cells vaporize. You can do a laser cone as well, which is a less invasive option than a cold knife or leep cone - and seems to have the same success . The reason its not done alone is b/c it doesnt go as deep as the leep does, so the deeper abnormal cells do need the leep

Hope this makes sense!

phaedrus · 03-17-2005, 07:47 AM

Thanks so much everyone for your input. I don't even know if this guy is a regular gyn or an onc/gyn. I will find out. He never explained to me exactly how much of the cervix is covered but he was training another doctor when he did my biopsy and he commented to the other dr quite audibly that "look at all those cells, that's a lot of cells that are showing up...." He actually sounded quite surprised himself. I will look into getting another dr. Unfortunately I live a town that is known for the lack of Drs in the area.
Still, thanks for sharing, now I have more idea of what to expect. I read the posts from the other thread about Leep...yikes. I would opt for being out. I am glad not everyone had neg experiences awake, but I would rather not know what is going on.
Hope everything goes well with everyone's future results/procedures.