What to do. Lletz or biopsy?

Just looking for other people’s thoughts on this. I had an abnormal smear a few weeks ago that said ?glandular neoplasia. Had my colposcopy this week and the consultant said she could see a very small lesion on my cervix that looked like it could well be cgin judging by its appearance which would tally with the smear result. I did not want Lletz there and then which she was fine with. She did say she could have done a biopsy but if it confirmed cgin I would need Lletz and if it showed something much less I would still need Lletz to clarify things. Thing is I really only want to go ahead with Lletz if absolutely necessary as I have had all sorts of other health issues and tests over last couple of years and am worn out by it all, but also the anaesthetic and possible infection risk/need to take antibiotics could make me quite ill again. (Long story)
I tried to explain this to the consultant but it was poo pooed a bit even though she was lovely. I’m scheduled for Lletz in two weeks but wondering whether to just have a biopsy to begin with and go from there. I’ve read smears can be inaccurate and some glandular changes can be for lots of other reasons. I’m in my forties and first ever abnormal smear. Thoughts anyone?


The difficulty with having a biopsy they only test a small area where as if you have LLETZ the whole area is removed and sent for biopsy. The biopsy could miss abnormal cells so for example my smear came back as severe dyskariosis but my biopsy was mild to moderate so I don't know what's accurate so I've had LLETZ and I am waiting for my results which will biopsy the whole area and I've been told there could be severe cell changes that the biopsy may have missed. Also you could have a biopsy and may need LLETZ anyway from the result you get, meaning another invasive treatment. If the consultant says you need LLETZ then I'd go with her judgement as she sees this every day, I hope that helps. 

Hi Abilene, 

My advice would be to have the LLETZ in case they miss something with the biopsies, as Sunflower said above. My experience was that I had an abnormal smear, biopsies that came back as CIN3 so then LLETZ to remove the CIN3 and when they biopsied what they had removed during the LLETZ, that is when they found the cancer that had been missed on the biopsies. 

Best of luck with your treatment once you decide how to go ahead. 



It's a really stressful time and it's understandable that you are apprehensive.

I have to say I'd have the lletz. I had my first ever abnormal smear at the beginning of this year, I had a lletz the same day as my first colposcopy. I had 2 areas of high grade CGIN and higher up in the lletz sample adenocarcinoma. If I had not had the lletz they would not have discovered the cc as it was glandular and further up the cervix. I don't want to panic you in any way but it's worth knowing that glandular abnormalities are inside the cervix so sometimes not accurately diagnosed by biopsy alone.

Good luck xxxx