Can borderline changes ever be cancer

Hi, has anyone ever have an hpv+ and borderline cell changes smear and then been told its worse or even cancer after a colposcopy? I’m thinking no but my mind is going in overdrive since my smear result. Just need to be told I’m over reacting!!

Hi @Buck

It wouldnt be very likely that they would find cancer after a borderline change, although smears are only an indicator, they do describe how different the cells look from normal giving the colposcopist an idea of what they should expect to see, it is possible they may find a higher grade than the smear had indicated however there is a huge difference in how the tiniest subtle changes/ones that look abnormal enough to be classed as a dyskaryosis look from cancerous ones…

Borderline changes isnt considered to be a precancer and is the equivelent of having a borderline blood result, still normal but on the verge of being abnormal… if cancer was found after this result there would need to be a huge f*ck up somewhere and although high grade lesions can present as lower grade ones and vice versa, with this change its much more likely that they will find inflammation/signs of the virus being active within the cells or CIN1 rather than a true precancerous lesion xx

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I had my colcoscopy and the consultant told me I have pre cancerous cells and he did the loop procedure there and then under local anaesthetic. I also got a biopsy of my womb. Just waiting on results now xx

Thank you for replying. I don’t know what CIN or dyskaryosis are? My head just went down a worm hole when I got my smear results back as I really don’t want a colposcopy, it’s my 3rd year hpv+ and was just hoping it was going to be gone this time. You’ve put my mind at ease though, thank you.

I’m sorry you had to have that. Did your smear come back with just borderline too?

Smear results can come in many ways and when they describe how the cells look they put them into categories based off how different they look from normal cells…

Dyskaryosis is just a fancy word that translates into “changes of the cells” as the smear has only described what they look like and not everything that is picked up by a smear is a potential precancerous change, many things can cause an abnormal smear so they need to do a colposcopy to identify if what was picked up was caused by the active HPV (active HPV/inflammation only or precancer) or something insignificant… if precancer is found, its known as a CIN which is an actual change in the cells

Most commonly smear results come in the form of:

  • Borderline change: this is the lowest of changes, as i say the cells are pretty much still normal just with a subtle change and isnt enough to be classified as a low grade change… this could be from anything along the lines of vaginal flora, sex/menstruation too close to the sample being taken, a cervical infection, signs of an active HPV infection or it could be the beginning of cells starting to change - a colposcooy is more of a precaution with this change than a cause for concern
  • Low grade dyskaryosis: the cells appear to have a low grade change to them, they expect to see CIN1 with this result, although a CIN its not seen as a cause for concern as iys not seen as a true precancer, it usually goes away on its own so it will be monitored with a repeat smear rather than treated unless it persists over a certain time or progresses to a higher grade
  • High grade moderate dyskaryosis: the cells appear moderately abnormal, they expect to see CIN2, there are still many cases of regression but they are more inclined to treat these changes (people can still opt for monitoring depending on certain factors)
  • High grade severe dyskaryosis: CIN3 is expected from this result, this is the direct precurser of CC and seen as the true precancer as this grade has less chance than the other two (there are still many cases who have regressed) so its treated ASAP as if it does progress the next stage would be CC
  • Some have had a severe (?invasion) result: this means they expect CIN3 but they are also looking for an invasion as the smear has indicated malignancy could also be present

Although all grades of CIN can regress, the more severe it is the more likely they are too remove it as theres no indication of whos cells will regress and whos may potentially progress xx

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Hi @Buck - if it helps, my smear said low grade changes and at my colposcopy yesterday she told me the results were borderline, during the colposcopy she found CIN1 and took a few biopsies to confirm. She doesn’t expect mine to come back as anything other than CIN1 based on what she saw… and I’m still worried she’s wrong :laughing: x

It’s all a worry isn’t it. Feel like it’s all a waiting game for it to turn into something worse. How long did you have to wait for your colposcopy?

Not long thankfully, my smear was April 18th, it took about 6 weeks for those results to come through then the colposcopy appt came through a couple of days later for the 22nd. She said it’d be 2-3 weeks for the results because they prioritise the biopsies so overall, not bad from results to results if she’s right. (I don’t count the smear wait, I wasn’t really worried, although I wasn’t surprised to get the HPV+/changes, if that makes sense.) I’m getting through it by reminding myself that no matter what the results are, it’s an answer, and any answer is 100x better than not knowing.

I have horrid heavy/painful periods which is where my anxiety comes from, I know something is funky down there because of my symptoms but I’m waiting on the biopsy then I’ll badger my doctor again. She’ll just tell me to wait otherwise!

So you had borderline changes on your smear the CIN1 at your colposcopy? Sorry, still trying to understand all the different terminology. CIN is worse than borderline isn’t it? What were the biopsies for, to confirm that result? Hopefully you’ll get them back soon. Yeah like you say, all of this is worth it as it prevents anything worse doesn’t it. Just hard to get your head round all the different terms x

My smear results said HPV positive with low grade changes which is what CIN1 is classed as. At my colposcopy, she said my results were actually borderline for changes (I guess she had more info?) but during it she noted that I do have CIN1 cell changes which are in awkward spots, basically the outer edges of my cervix as opposed to in the ‘usual’ spot of the middle. Yes, biopsies just to confirm it because the colposcopy isn’t truly diagnostic like that is.

It is really hard to get your head around it, I swear I kept this website open on a tab on my phone the whole time and read everything a thousand times. It felt ridiculous sometimes but between the info on the main site and lurking on the forum, I was prepared by the time I went in which I’m glad about now because I sort of spaced out through a lot of it x

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Yeah this site is really helpful isn’t it. I feel much more at ease now knowing mine is just a precaution, same as if it had just had hpv+ this time again at its my 3rd one i still would be having a colposcopy. It’s just I had changes this time as a little added extra lol!

Hi girls, so I don’t want to write another post so hoping you’ll have some advice. This may well be TMI so I’m sorry if it is, I’ve been uncomfortable today and hubby and I had sex last night. Tissue was ever ever so slightly pink on doing a wee last night. Should I mention I considering my smear result, albeit a non worrisome result?

Hi @Buck

Its probably nothing to worry about but i would give it a mention, any kind of bleeding thats unusual for us should be reported and does usually get explained away by something unconconcerning

Is this the first time youve experienced this? The most common cause for bleeding after sex is a something called a cervical ectropion/erosion, its completely harmless and its fairly common… i have one but wasnt diagnosed with it until i had a colposcopy xx

Tbh its not that often we have a bit of fun these days, 3 kids and long hours working etc etc so it’s been a little while lol!! Not the first time I’ve felt uncomfortable recently but Im noticing it more today. Not bleeding today so I’m not overly concerned, just think my mind is wandering. I’m assuming my colposcopy will be in a couple of months considering it’s precautionary, just need to forget about it until then I guess

Could just be that your on high alert and its usually within 6 weeks for low grade and below, but waiting times can also be down too our location, my first abnormal smear was for borderline changes and i was seen within the 6 weeks xx

Oh that’s not too long to wait then. Yeah I think I’m just over analysing everything. Chances are ill go to the colposcopy and there won’t even be borderline changes xx

I had normal smear and HPV results in Dec but was referred for colposcopy because I bled a lot during the smear and also had some bleeding between periods/ sex etc. The colposcopist thought it was CIN 1 but results came back as CIN 3 with severe dysplasia and pre cancerous cells. Just had them removed under general and waiting for results. Scares me to death as smear and HPV were wrong, colposcopist didn’t get it right with his observations either :smiling_face_with_tear:

Oh wow, will they look u to why the results where not right from your smear? Are you all good now? Sorry that you had to go through that. I’m still waiting for my colposcopy appointment to come through x

Nobody seems to have any answers as to why HPV test and Smear were normal…thank god I bled as much as I did during the smear or I would never have been referred and then it might have been another 3 years before next smear and then who knows??? Still waiting for results of LLETZ…the waiting is a killer :smiling_face_with_tear: