Discordant results

Hi all, late May 2015 I had a smear - I was one year late on this as we were busy with health problems with a family member the year before - as the nurse took the smear she said I had a very large neoplasia (I think that is the word she used). Her only comments were they were quite common in women of my age (mid 30s), she never mentioned it would mean my smear result was probably abnormal. So my results came back as high grade abnormal and I was referred for colposcopy, which I had on June 25. They took a number of biopsies, I can't recall exactly how many but I feel it was 3 or 4. The doctor said it would need treatment after looking at it, and showed me pictures he took during the colposcopy and it did not look like a normal cervix it looked like CIN3-ish from pictures I have seen online. I had not got my results back so called today, the nurse told me that the doctor had not looked at them yet but relayed to me over the phone that they were for 2 biopsies (again I feel I had more than this, but maybe I am wrong) and they were both within the normal range. I was a bit confused about this and queried it with her if it was common for the smear to show high grade, and to visually look like it needed treatment, but for the biopsies to be ok. She said it was not, and that once the doctor had looked at it their next step may be to discuss it in a multidisciplinary meeting. From what I can find online this is called discordant results, and usually requires a case review (in a multidisciplinary meeting), HPV testing to confirm the next action, and not sure what else. The nurse said the doctor may get to looking at the results in the next week or so. At colposcopy he had said it would be 4 weeks, which I had waited (until today) and when I did not hear anything, I called. Just feeling a bit frustrated as I feel like this whole process is so lengthy, and now it is going to be dragged out even more. Has any one here had discordant results like this before, and what ended up happening in your case. BTW I am in New Zealand but could not find an amazing forum like this here to ask locally. Thanks so much.

Hi there, I have something similar. My Smear test showed high grade Dyskaryosis (Moderate) and also low grade, but the biopsy was clear. I am having the Loop treatment today, from what I can gather the results can be different, it could mean that there wasn't enough cells to look at the biopsy. I was a bit confused at first thinking do I really need the treatment, but i'm happy i'm having it now, as the cells will be gone and hopefully thats the end of it. I also have high risk HPV, so that's another reason for me to just have the treatment and get rid of the abnormal cells.

If I found anything more out from my consultant today, I will let you know.

Gina x

Thanks Gina. I think that is great you are getting the loop treatment. I would much rather have the treatment than not. The nurse today was very 'both within normal range so that's all you be needing/or hearing from us' can't recall her exact words but it was like she was trying to say I would not need treatment. Then I was all but but, wait, my smear was high grade...Will have to wait to see what the doctor says when he finally gets round to looking at it. Good luck for your treatment.

Thank you... also, here in the UK they do HPV testing at the same time as the smear. From what I can gather they have not tested you yet for HPV?

I would be surprised if they don't carry out treatment to remove the abnormal cells on you, keep chasing and hopefully you will hear soon.

x

I am not sure re. the HPV testing. I don't think they do it routinely, only if other results indicate you should have. In all the smears I have had in NZ I have never had HPV results reported to me anyway. I did have it done on my last smear before this one, as we were living in the states at that time and the HPV test was routine there. It was negative at that stage but I know that does not mean much as the infection can come and go.

Hiya

 
I have had something similar - smear showed high risk HPV and moderate dyskaryosis, plus the gyno saw some abnormal cells during colposcopy (shown in white on the screen.) However both the two biopsies that I've had were 'inconclusive' as nothing was seen. My doctor explained that this could mean the abnormal cells are out of sight and recommend I have lletz to remove these, apparently the lletz reaches further up (out of view) than a biopsy can. I am now awaiting results of the lletz and am hoping and praying that this has removed everything. I hope you hear back from your doctor soon. Waiting is just the worst! 
Xx
 
Aug 2013 - turned 25, clear smear result
Jan 2015 - smear taken as part of routine 'full body' health check-up - results show HPV 16 high risk, and CIN 1 confirmed
Jan 2015 - colposcopy, CIN 2 confirmed, biopsy taken - results inconclusive, return in 6 months for another colposcopy
July 2015 - 6 mth repeat colposcopy - abnormal cells seen, biopsy taken, and smear
July 2015 - smear results show HPV 16 moderate changes, biopsy result inconclusive (again) - lletz carried out. 
Awaiting results, due in 2 weeks

Hi. I am in NZ too and have found this forum very helpful!  I.Ve not heard of HPV testing being done routinely over here.

When I started this journey the doctors were clear that if there was a difference between results and what they see ( e.g smear showing high grade change but biopsy show cin 1 (low grade) then further investigation would occur.

 

I would continue to ask questions. ..unfortunately sometimes the medical professionals can make you feel silly for asking , but it's your body and it's your change to get the accurate diagnosis 

Hope this helps ? 

 

I had High grade smear (may) Sent for biopsy (June ) Doc looked and said looks ok probably only cin 2. Results back cin3. Sent for lletz on 15th July . Awaiting results. 

Thanks for all your comments. I finally got my results letter back and it just says very briefly about the biopsies showing no sign of abnormality and will repeat colposcopy in approx. 3 months. There is no explanation of anything which I find frustrating, and I know I could call and ask but I found them really unapproachable last time so I am thinking for paying for a repeat one private to get it done sooner and get a second opinion. Also to have someone actually explain to me what it all means. How can you have high grade on smear and CIN3 suspected from colposcopy (so obv. looked bad) but then within normal range on biopsy. I understand one option is the biopsies were not of the right areas, but is there also the option that you can have cervical lesions that are not precancerous and don't needed treated? So confusing!