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cervical cancer and pathology report cervical cancer and pathology report

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Unread 03-19-2004, 01:27 PM
cervical cancer and pathology report

I am new to this board, after reading back through several pages i called my doctor to get a printout of my pathology report. i have my annual pap in jan, to come back abnormal. i had a Copo in Feb, which came back mild/severe dyaplasia, i had a LEEP march 8th, which came back stage 1a cancer, i see the GYN/ONC april 5th. ok this is my history....i was reading about peoples margins being positive or clear, and wanted to know more about mine, i was in such a shock last week when i went in to talk about my results (i should have known somehting was bad then) it says

-transformation zone cervical mucosa with micriinvasive squamous cell carcinoma
-extensive carcinoma in situ with extensive endocervical glandular involvement
-seperate focus of cervical glandular intraepothelial neoplasia high grade (adenocarcinoma in situ)
-carnicinoma in situ at endocervical margin multipocally (see comment
and comment was
A- the focus of microinvasion is approx. 1 MM deep and 3 mm wide. this leasion is stages at figo stage 1A1.
margin elvuation for involvement difficult in this speciman due to orientation.

anyone know what any of this means? i have been looking for hours on the internet with not much luck. i will check back for responses! thanks a bunch!
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Unread 03-19-2004, 01:31 PM
cervical cancer and pathology report

Hello Dagiffen,

I wish I could help you more, but I think others will come along who've had direct experience with cervical issues and they should be of help to you.

Sorry that you have to deal with this at all....but you will find lots of support and information here.

I see that you are consulting a gyn/oncologist. They are the experts in all this and you may find that seeing one, even for a second opinion, is helpful.

We're here to get you through all this...so don't hesitate to write!

Unread 03-19-2004, 01:37 PM
cervical cancer and pathology report

It sounds like you have stage 1a1 adenocarcinoma. That means it's very small and very treatable. Sorry I can't help more, with all the details.

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Unread 03-19-2004, 01:47 PM
cervical cancer and pathology report


Sorry to hear that you have received bad news. However, it sounds like even though you have cancer, it has been caught very, very early.

Here's what I am gathering from the report you have given us (keep in mind that I am not a doctor).

The transformation zone is that section of the cervix where there is a change from one type of cell to another. The lower end of the cervix has squamous cells. The upper region has glandular cells. So, the cells start a gradual changing process in that mid-region. And it sounds like that is the area where they found your microinvasion.

You also have involvement of the cells higher up in the cervix (glandular cells), but it does not sound as if they are invasive as yet. You had several areas of ACIS (adenocarcinoma-in-situ) at the margins of the specimen. Which means that you may not have clear margins. Adenocarcinoma-in-situ is still a pre-invasive condition of those glandular cells higher up in the cervix.

The good news is that your invasion is very small. The bad news is that they may not have attained clear margins, therefore you will likely need some additional procedure or surgery. Fortunately, you already have an appointment to see a gyn/onc which is great! They are the experts when it comes to female cancers and precancers, and they know all the most current surgical and treatment procedures.

At stage 1a1, you most likely will not require any chemo or radiation after your surgery or procedure (to be determined by your gyn/onc). At 1a1, the invasion is so small, that it really has not had any opportunity to spread anyplace other than the very immediate vicinity.

Good luck! Please let us know how your appointment goes. And feel free to continue to post any questions or concerns you might be having. There are several ladies here who have been in similar circumstances, and I'm sure you'll be hearing from them soon.

Unread 03-19-2004, 01:49 PM
cervical cancer and pathology report

Let's see if I can shed a little light for you from my experiences...

Transformation zone: This is the area that the columnar cells turn into squalmous cells. This is where cancer will ususally begin. Your report says that where the cells have changed into squalmous cells there has been significant change.

Endocervical glandular: Stage zero found (has not gone beyond the initial layer and therefore is not considered invasive) in the columnar cells in the cervical canal (past the cervix and into the uterus.)

Most of the rest says basically the same thing except at different areas.

The micro invasion is the one of greatest concern because it has gone beyond the initial layer and has invaded the tissue below. However, it seems that it is still very localized. Usually this means a hysterectomy and nothing further if everything looks good during surgery. They will take the uterus (once removed) and open it up to do a visual check before sending it off to the pathology lab. Your doctor will check your ovaries to see if they look healthy as will he with the surrounding tissue. If he is more conservative, he may take some lymph nodes to check.

For stage 1A1, a hyst is usually all that is needed. My guess would be a TAH so that they can check everything out.

I hope that helps. I am sure someone will come and give you more and better info.
Unread 03-19-2004, 04:14 PM
cervical cancer and pathology report

I think that the "at margin" means that your margins were not clear (at least of the carcinoma in situ). I think that the comment deals with them not being able to tell if your margins had invasive cervical cancer. I asked a friend who is a Dr. when I got my LEEP pathology report back for CIS as mine said lesion "close to margin" (versus at margin). I was told this meant my margins were clear and that if they weren't the pathology report would say dysplasia at margin. As far as endocervical glandular involvement, I had that too - I had trouble figuring out exactly what it meant. I think that you have glandular cells with the other cells in your cervix. The glandular cells can also show dysplasia - this unfortunately is a good predictor of reoccurance. This is different than adenocarcinoma, which also affects glandular cells.

I agree that you will need some other form of treatment. You would need more treatment even if you do not have invasive cancer at your margins (because you do have CIS there). Depending on the depth of your original LEEP and any desire you have to preserve fertility, they may be able to either repeat the LEEP cone or do a cold knife cone. For very microinvasive cervical cancer, these procedures have similar "cure" rates to hysterectomy (if they can reach the bad tissue). But it is very possible you will need a hysterectomy. Because they caught it so early, a hysterectomy will probably be the most you will be facing.

Finding the bad cells at the transformation zone is very common in cervical dysplasia and squamous cell cervical cancer. It appears that HPV, the virus that causes cervical cancer prefers this particular area. In many women, if they remove the transformation zone and the margins are clear, squamous cell changes don't come back.

Good luck The good news is that because they couldn't tell for sure about invasive cancer in your margins, maybe they got it all with the LEEP.
Unread 03-19-2004, 04:35 PM
cervical cancer and pathology report

wow you guys have been more helpful than the OBGYN. i was somewhat of a wreck while i was there, i did not take my husband, i dropped my son off to him at work and went thinking i was just being briefed on the LEEP....i never thought it would turn to cancer so fast. i do want the hysterectomy, i have 2 children and do not plan to have more, my youngest is now 4 and we have been sure since he was born we were either having more right away, or not at all. i had preterm labor with both children, and do not want to go through that again either. i wanted a hysterectomy instead o fthe LEEP, but my doctor would not listen to me. i feel so much better after reading your comments, i have sat and looked up all of the terms and still not making much sense of it. i read CIS was displasya, and was still trying to figure out where is the cancer comming from? now i am assuming it is the microinvasive squamous cells? i wish i could go to the GYN/ONC sooner, but they could not book me for 4 weeks out due to the LEEP, they said i needed time to heal first, which really scared me. i had the copo in feb which said moderate/severe dysplasia, and a LEEP a month later that comes back cancer, i was thinking a month could change alot! i do remember my doctor saying there was a chance the LEEP got all of the cancer cells, but i would still be so much more comfortable with a hysterectomy.

what is TAH? i could not find anything telling me what it stood for?
Unread 03-19-2004, 06:58 PM
cervical cancer and pathology report

a TAH is a total abdominal hysterectomy (removal of the cervix and uterus).
i had one on 2-17 for stage 1A cervical cancer.
my doc told me that for adenocarcinoma (which is what i had), in order to be sure the cancer hadn't spread, he recommended a radical hysterectomy (removal of the cervix, uterus, a small portion of the vagina and several pelvic lymph nodes).
i did get to keep my ovaries, though (good news because i'm only 33).
after my surgery, my pathology report showed that the cancer was just in my cervix and they indeed got it all!!! hopefully you'll have the same results.
if you have any questions, feel free to ask.
best of luck to you,
Unread 03-19-2004, 07:32 PM
cervical cancer and pathology report

you've gotten a lot of good information from the women here.I just also want to give you some encouragement that everything will be fine.It definitely sounds like it was found early enough to be completely taken out with a hysterectomy.I had a cone biopsy back in june because i was pregnant, and then ended up having a radical hysterectomy after the baby was born this feb.and I'm happy to say that the cancer had not spread beyond the cervix and I need no further treatment beyond frequent check-ups for the next few years.
I know that waiting is probably the hardest part but everything will work out fine.
Unread 03-19-2004, 07:33 PM
cervical cancer and pathology report

It sounds like you have stage 1a squamous cell carcinoma and adenocarcinoma in situ. A hysterectomy should be curative. 1a is sometimes treated with a total hysterectomy and sometimes a radical. A radical would remove some lymph nodes for testing and the upper part of the vagina in addition to the uterus and cervix. I had 1a adenocarcinoma with squamous cell carcinoma in situ. It has been over 2 years since my hysterectomy and I am fine.

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