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leep result back with unclear margins!? leep result back with unclear margins!?

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Unread 08-04-2003, 12:56 PM
leep result back with unclear margins!?

Hi everyone,

i've been reading the board, but haven't wrote in awhile. In the meantime I had the LEEP done about 2 weeks ago under general anesthesia (which i recommend, was much better than the colposcopy/biopsy), and recovery was pretty easy, just a little tiredness, mostly from the anesthesia. But now my results are back and my doctor said the margins are unclear. I understand that this means they didn't get everything, but does this mean that it is invasive? I was diagnosed with HGSIL/CINIII/carcinoma in situ before the LEEP. Does anyone know if this means it could be cancer, and if so what are the chances? I know these are pretty specific questions, but any ideas would help! Also, for a little background, my pap before the one that was abnormal was only 6 months before.

Also, my doctor said that we can't do anything until october because the cervix will be healing--is this right, can nothing be done? I do like and trust my doctor, but should i see a gynecologist/oncologist now? and does anyone know what steps usually follow after having unclear margins after the LEEP!

thank you in advance for any advice, the advice and support i have gotten on this board is very much appreciated and needed!
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Unread 08-04-2003, 02:35 PM
leep result back with unclear margins!?

Hi Sophie,

Sorry to hear that you are dealing with this right now. I will try to answer some of your questions as best I can and I know others will also be along to help.

First, not having clear margins does not mean the cancer is invasive. It means that the lesion can be found outside the area that was removed. Let's say the lesion began right on the line where the sample was removed. Part of it would be in the sample, and part of it out. Therefore, you cannot be sure how much further the cancer went, but it does not necessarily mean that the cancer is considered invasive.

You have a diagnosis from before the LEEP, but apparently not from after since your doctor only mentioned that the margins were not clear. You should ask to see your pathology report from the LEEP itself if you'd like more information.

About whether this is could be cancer or not: It is difficult to get an estimate of how many cervical dysplasias become cancerous, but the number is actually surprisingly low. The risk of a cancer developing increases as the stage of dysplasia gets higher. I can't give you a number though, not sure what it is.

Also, you said that your pre-LEEP diagnosis was carcinoma-in-situ. There has been many a discussion on this board about whether that condition is cancer or not. Depending on who you ask, CIS is either very high-grade dysplasia or very low-grade cancer. But either way, it is relatively easy to remove the abnormal cells, so don't panic even if CIS might be considered cancer (easier said than done, I know!).

As for your doctor's suggestion to not do any further treatment until your cervix heals, from my own experience and what I've read on this board that is a very common recommendation, and one that seems pretty reasonable. To answer your question about seeing a gyn-onc, my answer is yes, 100%, absolutely, positively ! They are the specialists in this area and will be able to answer your questions about any and all treatment options and give you some peace of mind. Very best of luck to you.

Unread 08-04-2003, 05:03 PM
leep result back with unclear margins!?

Hi Sophie,

No, unclear margins does not indicate that the cancer is invasive. It means that they might not have grabbed all the bad cells. The report from my last Cone had a comment that they couldn't be sure about the margins because the tissue sample was torn. They did another pap 3 months later and it came back abnormal. I had the hyst and there was no invasion.

I do think a consult with a gyn/onc is always in order. It has nothing to do with your confidence in your dr. Gyn/onc's deal with this condition all the time and are the experts.

My final dx was CIN3/CIS. As Beth said, there are differing opinions on whether CIS is a Stage 0 cancer or a pre-cancer but the bottom line is that CIS means no invasion and it is treated in the same way as a pre-cancer.

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Unread 08-04-2003, 09:33 PM
leep result back with unclear margins!?

The women here have given you good information. Because the margins were not clear, the doctor will probably want to do another procedure. Another LEEP, a cone biopsy or hysterectomy might be recommended.
Unread 08-07-2003, 05:03 AM
leep result back with unclear margins!?

Hi Sophie,

My journey began with an abnormal PAP, followed by a colposcopy and biopsy, then a LEEP and cone biopsy which showed definite cancer cells with unclear margins.

It was then that my GYN referred me to my ONC GYN to take over. Since I had definite cervical cancer, my options were either radiation/chemo or a radical hysterectomy. I opted for the surgery because of a number of factors, including my age, not wanting more children, and mostly because I just wanted the cancer out!

I had to wait 6 weeks from my LEEP/cone biopsy for my hyst, because the cervix needed to heal. I can't say exactly why this is, especially if it's being removed with the hyst, but it seems to be common procedure and I'm sure there are very valid reasons for it.

Best wishes and lots of s

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