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Anyone have final pathology change? Anyone have final pathology change?

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Unread 11-24-2006, 04:45 PM
Anyone have final pathology change?

I have read about women going in for surgery with a grade 1, stage 1 diagnosis from a endometrial biopsy, and ending up with a "more concerning" grade and/or stage after the final pathology report from the hysterectomy.

I'm just curious if anyone here experienced that? (Trying not to worry or play the "what if" game...but, you know.....)

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Unread 11-24-2006, 06:21 PM
Surgical staging

Hello Trustinghim,

I'm glad you're being sensitive to the "what if" game we all play. That's a tough one, I played it too.

But the pathology report from a surgical staging hysterectomy--where they examine the uterus, ovaries, fallopian tubes, lymph nodes, and pelvic washings--can indeed result in a higher stage or grade than before the hysterectomy. That's because the oncologist cannot tell the extent of spread of cancer cells until they examine everything post-surgery.

I didn't know any of that going in to my LAVH. My D&C indicated cancer so I was scheduled for a hysterectomy right away. I only learned later, after my surgery was done by my gyn instead of a gyn/onc that my pathology indicated I had at least a Stage 2 cancer (spread to the cervical canal). So ... I had a second surgery (this time by a gyn/onc) to finish the staging. Not the best way to do it, but for my peace of mind I wanted to know.

I believe there are others on this forum who also ended up with a higher stage after surgery.

Good luck, keep us posted.
Unread 11-24-2006, 07:03 PM
Anyone have final pathology change?

I had surgery on sept. 1st to de-bulk and biopsy 2 ovarian tumors, and the patholgy came back as borderline. The second surgery, later that month, removed all of the tumors and the final pathology came back as stage 1c invasive carcinoma. I think what happens is that the more tissue that's removed, the more area they are able to test for cancer. In my case, there was a 6 mm invasive tumor that was missed with the first surgery and found only after everything was removed and tested.

Good luck to you! Ask a gazillion questions. Knowledge is power.

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Unread 11-24-2006, 07:54 PM
Anyone have final pathology change?

Statistics are tricky because you aren't a statistic - you're an individual - but I think most of the time everything turns out more or less how the doctor suspects. I was upgraded to stage III however, after the surgery and the pathology reports came back.

You may get a lot of responses here about how after the hyst the staging was upgraded to something more serious - because this is a thread visited primarily by people undergoing treatments. People whose surgeries and pathologies turn out just as suspected generally don't need further treatment, so they don't hang out for as long.

Upgrades happen - but not to everyone. Please know that each situation is different - but no matter what, there are people here who care and can answer questions - or just offer support.

Good luck!
Unread 11-25-2006, 05:14 AM
Anyone have final pathology change?

hello- I had a biopsy first(atipical cells), then a D&C which confirmed cancer of the uterus.No staging made at this point. Was sent to a cancer specialist, who did the LAVH, remove omemtun, lymph nodes, washings and here is what he found according the pathogy results. Two locations of cancer in my uterus, a different kind of cancer of my cervix and a cancer tumor next to my lymph channel. My omentum came back negative, along with the lymph nodes and washings. (thank goodness) my staging was endometrial cancer stage 2b and refered to radiation treatments. It's scary with the thoughts of "What if's" so the only thing I can suggest is to stay positive and don't let this make you crazy. The only thing I hate is when people say "Did they get it all out"? I really hate it because my oncolgist says........Hey, this is what we know about you.....we know that your body knows how to make cancer so at this point we keep a close eye on you". That is exactly what I wanted an HONEST answer, no beating around the bush. Hang in there.
Unread 11-25-2006, 03:02 PM
Anyone have final pathology change?

trustinghim: I hear the stage can be upgraded too. BUT, if it helps you to feel better some (hopefully most) stay the same as first dx, and sometimes even are better or easier to treat than when first discovered. Mine was staged at 1A grade 1 after d & c (the prior biopsy said complex hyperplasia w/atypia), but it stayed 1A after the 2nd pathology report. (There was a little difficulty in staging that and as first path came back as stage 0.) So, here's hoping yours too stays the same, or better!

Try to think positive thoughts! I have to tell myself that still! Every little bump and ouwwie gets me nervous now, and I have to talk myself down, away from that edge! The best to you all!
Unread 11-25-2006, 05:11 PM
Anyone have final pathology change?

My endometrial biopsy showed precancer cells (complex hyperplasia/atypical). After surgery, the final pathology showed actual cancer. I was stage 1B Grade 2. with <I0% invasion into the uterine wall... guess we really never know what could actually be going on in our bodies. Sometimes tests just don't show it all. It's all scary no doubt.

Good luck to you!!!! You have my prayers!!!!!
Unread 11-25-2006, 07:02 PM
Anyone have final pathology change?

Precisely why it is so important to have a gyn/onc do the surgery so everything can be properly checked, removed, and tested. There is plenty of speculation about stage and grade before the surgery but things aren't always what they seem.

My cancer was detected by endometrial biopsy and appeared to be well-differentiated and caught early so thought to be Stage1 Grade 1. Unortunately one of the sampled nodes came back positive so that bumped my stage up to IIIc and dictated what the appropriated plan of treatment would be - my grade stayed the same, though. Sure I would have been much happier keeping the Stage 1, but I am so thankful that we knew of the spread through proper staging.

If you're not already seeing a gyn/onc, do yourself a favor and do so.
Unread 11-25-2006, 09:02 PM
Anyone have final pathology change?

Thank you, everyone for your responses. Evidently it (upgrading) is more common than I thought...but I'm becoming more at peace with the whole thing. It seems to take a while to adjust to the idea of a cancer diagnosis.

I won't be seeing a gyn/onc but I do know my 2 surgeons (wife is gyn, husband is general surgeon) have many years of experience in both hysterectomies and cancer staging.
Unread 11-25-2006, 10:02 PM
Anyone have final pathology change?

No matter how much experience your gyn has, I hope that you insist that an gyn/onc be present to remove and test lymph nodes.
It is truly frightening how many on this board had to have additional surgery to check lymph nodes, etc. after surgery.
Not to scare you but there have been cases where radiation was necessary simply because staging was not fully done.

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