Cone biopsy confirms stage 1a1 SCC

Hello All,

This website has been so helpful and I just wanted to share my recent situation. I am 31 years old and recently had a cone biopsy under GA (my first time having any surgery or anesthesia) due to an abnormal pap smear and colposcopy. I have just received my results that my margins are clear but that CIN 3 and a microinvasive scc staged 1A1 was found. There was no evidence of LVSI. My doctor feels comfortable that this is the end of the treatment (therefore, I found out I have cancer and that it has been removed in the same phone call). I have requested a hysterectomy but he said absolutely not due to my age and that it simply isn't needed.

For those of you that have been through stage 1A1, was a cone biopsy enough treatment for you? Did you stay recurrence free? Mentally, I would like to have a hysterectomy, as I am such a worrier and have spent every spare minute since my diagnosis googling and reading different medical articles. I do not function mentally at work, at home, etc. I just want to give myself the best chance at beating this or not having recurrence.

Given results are below:

 Associated with a micro-invasive, moderately differentiated squamous carcinomatous component present over a length of 2 mm. Its maximal invasion of the underlying lamina propria is estimated as a depth of 1 mm.

No neoplastic emboli within lymphatic vessels.

No endocervical glandular dysplasia.

 Endo- and exocervical resection margins free of both CIN 3 dysplastic and micro-invasive carcinomatous disease.


I was diagnosed 1a1 after a lletz for cin3, I then had a cone biopsy to be sure which was clear. I was a similar age to you. All was fine for 2 years then smear came back cin2 so I had another lletz. That was 2 years ago and smears have been clear since and hpv negative. I could have had a hysterectomy if I wanted but the mdt felt the treatment I had with follow up was enough so I'm going with that for now. I was worried about the side effects of the hysterectomy, one doctor said even if they left my ovaries, the reduced blood flow could put me into early menopause x

Hi Paris, 

i know you posted this a while ago but thought I'd comment anyway. I was diagnosed 1a1 originally in 2012 when I had a LLETZ - you can see from my signature what happened afterwards. I know how you feel about the constant worry, that was what played such a huge part in my decision making process to have a hysterectomy. I was lucky as I had a family at this point else I imagine my decision would have been different. We are all so different, some have treatment once and then that's the end, others are less fortunate and have reoccurrences. Hopefully you will be one of the lucky ones who never has to worry about this again, I'll keep my fingers crossed for you x x

Hi Paris117

I was diagnosed with 1A1 Villoglandular adenocarcinoma following lletz. I didn’t have clear margins so following MDT meeting I had a second lletz,this had clear margins.

 I discussed my options:

1. Simple keyhole hysterectomy keeping my ovaries.

2. 6 monthly colposcopy in view of adenocarcinoma. Although they couldn’t guarantee being able to see enough to detect early change adenocarcinoma as it is cancer in the glandular tissue so tends to start in the endocervical canal.

I have to say my decision has not been easy,if I had had squamous cell carcinoma I would’ve opted for 6 monthly smears and not gone for hysterectomy. Because I had adenocarcinoma and there is a risk of skip lesions and it not being detected I have opted for hysterectomy. I’m 39 and had my family. 

Good luck whatever you decide,take your time and allow yourself time to digest all the information you’ve been given. 



hello im in the same situation had a colposcopy where the consultant said he was sure i had cc i had results which showed cin 3 ,he decided to do a cone biopsy which came back as a1a cc, the consultant is sure the cone biopsy got it all,had an mri scan which showed it has not spread,also clear margains then consultant decided to do a second cone biopsy on the 5th march 2020 i was slighly shocked at heraing i had to have another ,when told margins where clear and mri scan that i didnt ask any questions and just agreed now im worrying wondering why ,if anybody has had a similiar experience any advice would be much appriciated thank you xx