Biopsy results - what does it all mean?

Recently diagnosed with cervical cancer
1

Hi,

My partner (age 35) has recently had a biopsy following a borderline smear and has received the results this weekend along with an appointment for later this week. We'd really like some help with regard to what the results mean and what treatment options are available and what others here would recommend so we can at least be asking the right questions at the consultation.

The biopsy results are as follows:

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CLINICAL HISTORY:

Pale a/w. Borderline smear. HPV detected.

 

SPECIMEN:

Cx Biopsy.

 

CERVICAL BIOPSY/LLETZ PROFORMA MACROSCOPY:

Specimen type: Biopsy

Number of pieces: One

Overall dimensions: 4 x 3 x 3mm deep.(1ng) (ap/ew)

 

MICROSCOPY: CERVICAL CARCINOMA

Type: Squamous cell carcinoma. Early stromal invasion only arising from a focus of crypt involvement by CIN3

Differentiation/Grade: Not assesable

Distribution of invasive component: Unifocal

Tumour size: Maximum horizontal dimension N/A. Maximum Depth of invasion 0.1mm

Invasive foci in three or more sequential slices of tissue? No

Excision status: Not assessable

Distance to closest resection margin: N/A

Lymphovascular space invasion: Absent

 

Other features:

CIN : CIN3

CGIN: Absent

SMILE: Absent

Excision Margins: N/A

 

COMMENTS:

Extensive CIN3 with crypt involvement and a single focus of early stromal invasion, in a diagnostic punch biopsy. Advise MDT discussion.

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Any decyphering of the above and advice at what is obviously a worrying and stressful time for both of us would be gratefully received.

Many Thanks,

Martin.

2

Hello Martin - I'm not an expert, nor a doctor, but I find it hard to understand why you were given  the above detailed report, not having it explained to you in full.?  

I suggest you visit your GP asap -  & have the results explained to you.  In my opinion  it's not for me or anyone else other than your GP or medical practitioner,  to attempt to explain this to you.  I don't say this to frighten you, but we are  not medically trained & therefore could interpret this incorrectly therefore I don't think it's appropriate for any of us to do so.  

I know this is a very worrying time for you both, so the sooner you are clear on this, the better.

3

The biopsy report was posted along with a covering letter and an appointment for Wednesday of this week. The letter mentions they may be able to carry out treatment at the same time. Obviously we will have an opportunity to discuss the report/diagnosis with them at this time but we are really just trying to research (in so far as possible) before the consultation in order that we know what the options are likely to be, the right questions to be asking, etc etc.

Kind Regards,

Martin

4

I am not a doctor nor an expert either, but if the letter says that treatment could be carried out at the same time you can rule some things out. You aren't going to be whisked in for a rasdical hysterectomy there and then for example.

 

Has your partner had scans of any description yet? My understanding is that Biopsies give an indication of the type of cancer, whereas scans tell how far (if at all) it has spread. Maybe this is a question you can ask. Will I be having a CT or MRI scan.

Ring the consultant tomorrow would be my advice. To be frank, sending results out like that with just a covering letter, is awful in my opinion. I'd be straight on the phone demanding answers. Cancer can make you very fiesty!!

Good Luck.

 

5

Hi,

Thank you to both of you for your responses. The biopsy results arrived with (but were not mentioned in) the covering letter. They also arrived without the appointment details that were referred to in the letter (my partner had to phone up yesterday to find out the date and time of the appointment). This just added to the feelings of uncertainty as the letter arrived in the post on Saturday morning so had the biopsy results, indication that an appointment had been scheduled, but unable to contact anyone until the Monday to find out when she would be seen (and consequently when we would have a more detailed understanding of the diagnosis and treatment options).

We suspect that what may have happened is that she has been sent the copy that should have gone to her GP and vise versa. We will certainly be mentioning this at the consultation tomorrow as if this is not what has happened and they do indeed routinely send out the biopsy results to the patient without explanation we feel strongly that this is the wrong thing to be doing as it really only adds to the feelings of worry and uncertainty.

I'll update the thread further tomorrow once we know more.

Thanks again,
Martin.

6

Hi Martin,

I just wanted to drop a message and say hello. Your partner is very lucky to have such a caring man in her life and it probably seems like you can't do much right now, but I'm sure she appreciates you finding out more. The best thing my boyfriend said to me when I was diagnosed was "whatever happens, we'll deal with it together". Those words helped me so, so much and he was true to them all the way through.

You're in the hardest bit now - when you don't really know what's going on, but you will feel better tomorrow when you know more. It's awful that the results have been posted out to you, so please do bring it up as it's certainly not helpful!

My advice would be to take in a list of questions and be sure to take notes/ask the questions if your partner is struggling a bit.

No matter what tomorrow brings, there's a huge amount of support and advice here for you both.

Best of luck,

Jo xx

7

Hi Jo,

Thank you for you kind words. You're right about feeling like I can't do much right now and I think from my perspective a lot of the 'research' is about feeling I need to be doing something in the absence of being able to do much else at this stage.

If you (or anyone else) have any suggestions as to questions we ought to ask, or questions you wish you'd asked at this stage but didn't I'd be very grateful to hear them. I'm sure we will come away with a better understanding tomorrow but I'm equally sure we'll then think of loads more questions we wished we'd thought to ask!

Kind Regards,

Martin.

8

Hi Martin,

I took in a big old list of questions but due to my diagnosis I didn't ask any of them really as it was just a case of asking what comes next...which was the MRI.

A good place to start would be:

- What exactly did the biopsy find?

- If anything was found, can it be treated in the clinic now? (e.g. by a lletz procedure?)

- Would any further tests be needed and how/when will they be scheduled?

- Do I need to stay in the UK at the minute? (just incase you have any immediate trips planned).

 

Hopefully your consultant/clinic staff will have all the info you need before you even have to ask anything extra - but the ones above should cover the basics just in case.

 

Take care, Jo

9

Hi All,

Just an update following todays consultation - it is apparrent that the biopsy results should not have been sent out to us and the consultant was rather horrified and very apologetic when we showed her what we had received.

That said, whilst receiving a report with the word 'carcinoma' on it is never going to be great, the flip side to that was that we went in today with a good idea of what we were likely to be told and therefore probably a little better prepared that would have otherwise been the case (I mentioned elsewhere about looking for the positives!).

The bottom line was that they have detected extensive CIN3 plus a single point of stromal invasion to a depth of 0.1mm in the small punch biopsy that was taken last time. They have carried out a LLETZ today and I guess the hope is that if the previous biopsy was representative of the level of invasion more generally, then there is a good chance that the LLETZ will be all that is required.

We should have the biopsy results from the LLETZ in about 2 weeks time - hopefully by appointment and not by post this time!

So it's fingers crossed in the meantime and back to playing the waiting game for now.

Thanks again to everyone who responded previously.

Kind Regards,
Martin.

 

10

Hi Martin,

Glad it all went as well as it could have done. Fingers crossed the Lletz will have cleared everything! Sounds like it was caught extremely early too.

Jo