ASCUS to CIN 3

Hi everyone,

I’m new here and have done a lot of reading and I’m ready to share my story so far. Oct. of 2022 I decided to make an OBGYN appointment because I am sick of having heavy painful periods and I had my first bout of abnormal bleeding (so I thought but apparently bleeding after sex also isn’t normal, who knew!). My period was 8 days long and then three days after it ended I spotted for three more days. I have always had moderate back pain the day before and first day of my period but in Oct. it hurt so badly I could hardly walk and the pain was deep in my right leg as well. The next month the same things happened. My back and right leg have been hurting since Oct. I have been having spotting for days from things that don’t normally cause spotting for me.

Anyway, I went to my OBGYN appointment in January and told her all of this. I wasn’t due for a pap yet since I’m in the US and had just had one two years prior (when I found out I was pregnant in 2020). She decided to preform a pap smear since I’m 30 and they tested me for HPV for the first time (stupidly I had thought this was being tested at each previous pap smear). The pap came back ASC-US (or borderline abnormal cells) and high risk HPV positive. This broke my heart as I’m a total germaphobe and I really really struggled and barely was able to eat or sleep the two weeks following. After reading a lot on this site I made my peace with that and decided there was probably nothing to worry about as the cells were just slightly abnormal.

I was booked for colposcopy due to the high risk HPV and my age. The OBGYN said my cervix looked really good but went ahead and took eight snips from three different locations and an endocervical curettage as well. She said she didn’t expect to see me back until next year for my more frequent pap smear. But the results came back and showed CIN 3 from two locations on my ectocervix (outer cervix) and the endocervical portion came back clear.

The doctor called me back and said she was wondering if I’m done having kids (I have two kids under 5) because she wants to do the cold knife cone procedure and it wouldn’t preserve my fertility. She is a very young doctor (32) and just became a doctor 4 years ago. I had read online that this procedure can ruin your fertility and cause sexual dysfunction so I decided to get a second opinion and transfer my care to a more experienced OBGYN. I feel a little bad about doing this but I had no peace about her doing the procedure since on multiple occasions she was unable to answer my questions for lack of knowledge and wasn’t even able to explain how these different procedures should be performed or what certain things meant (like ECC or which cells should “light up” after applying the vinegar solution during colposcopy).

I’m so nervous, I don’t understand why the pap smear said borderline but I’m actually on the borderline of having cancer. The pap and colposcopy were done only one month apart, and two years ago my pap was all clear. Can anyone share their CKC (cold knife cone) procedure stories, good and bad? Anyone end up with sexual dysfunction or other complications? I want to be prepared when I see the new doctor. Also, I’m worried about things progressing while I wait to see the new doctor. I know cervical cancer is supposed to be slow growing but my results might mean otherwise right? My appointment with the new doctor isn’t until March 17 and I will be starting the process all over with them with a pap smear and then waiting, then the colposcopy, then waiting again, and then I assume the LEEP or cold knife cone. I know I sound anxious, I am! Any replies would be so nice, thank you!

Hi @Shy_Magpie

I had treatment for CIN3 after a low grade pap smear 6 weeks prior (CIN1 just 13 months before this) its abit of a kick in the teeth when you get that confirmation… my treatment was a LLETZ still a type of cone biopsy but not the same so i cant really comment on a CKC, im just struggling to understand your pap results lol

Borderline changes and ASCUS arnt the same thing, so im not understanding how they can grade it as ASCUS but also call it a borderline change… borderline is just as you said, the tinsiest change, but ASCUS stands for atypical squamous cells of undetermined significance, this grade means it could be any grade of cell changes present they just couldnt determine what grade of difference in normality they were looking at, they just know they arnt normal or malignant, high grade lesions arnt ruled out when they grade it as ASCUS since they dont actually know what theyre looking at

Borderline changes that end up being at a higher grade at colposcopy, its usually down to a misread sample/wrong reporting or sometimes a lower grade can present as a higher grade or vice versa a higher grade can present as a lower grade… but when ASCUS is reported and a high grade change has been found/confirmed, as they couldnt determine the grade on the smear they cant be ruled out until the colposcopy/biopsy confirms the actual grade… smears dont diagnose our cells they just describe how different they look from normal ones, the only way to accurately grade them is by taking a biopsy… ASCUS explains your biopsy results more than what a borderline result would

Considering how quickly my cells went from CIN1 to CIN3 and how long it took from that severe change being confirmed to having my treatment, i needed it done under GA in the end, there was a 9 week wait between it so fully convinced myself they would find canver with the symptoms i was having and how quickly things had progressed… luckily this wasnt the case i still had precancerous changes only

I hope you can get some answers to your other questions and good luck with everything :slight_smile: xx

Thank you for your reply! The nurse who called me told me that ascus meant borderline changes so there was nothing to worry about but that the doctor wanted me in for colposcopy because of my age and HPV status. She acted very annoyed with me when I asked questions and told me “This must be your first abnormal smear…” like I was being overly worried about nothing. Thank you for clearing that up! This just reinforces my decision to transfer my care somewhere else!