Re: Gyn: Microinvasive Ca of Cervix
From: Efrain Ramirez (eramirezt@coqui.net)
Sat Apr 9 11:40:14 2005
I would like an onco consultation...
>At Fri, 08 Apr 2005, Andrew Folley wrote:
>
>I think I would be going with a hysterectomy in this 40 yo with micorivasion
>of cone (providing there was no lymphatic or vascular involvement) LAVH or
>vaginal if technically feasible. The patient would have to be highly
>motivated to risk trying to cocienve over the next 2 years in light of that
>history. andy
>
>>From: "R. Daniel Braun" <rd.braun@gmail.com>
>>Reply-To: ob-gyn-l@obgyn.net
>>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>Subject: Re: Gyn: Microinvasive Ca of Cervix
>>Date: Fri, 8 Apr 2005 13:17:33 -0500
>>
>>On Apr 8, 2005 11:58 AM, Joanne Bulley, MD <islesannie@yahoo.com> wrote:
>> > 40yo G0 - infertility, blocked tubes with some element of PCOS. one
>> > adopted child, 4 yo
>> >
>> > Paps:
>> > 95 - ASCUS
>> > 96, 97 - normal
>> > 98 ASCUS
>> > 99 normal
>> > (the above not in my office) (some years without paps after that)
>> > 2004 - normal
>> > 2005 ASC-cann't rule out high grade dysplasia
>> > 2005 colpo - invasive Squamous Cell ca -- unable to assess invison
>> > Cone (cold knife) 1.5 mm invasion.
>> >
>> > 1. What would you do?
>>
>>Oncology consult probably followed by TAH for microinvasive cancer.
>>
>> >
>> > 2. My guess is that if we had done the Reflex HPV back in 95 &/0r 98
>> > she probably would have been positive for the High Risk HPV ... would
>> > this have changed any management and would we have found this earlier?
>>
>>Maybe??????????
>>
>> >
>> > 3. The "normal" in 2004 (if she had had normals in 2000, 2001, 2002,
>> > and 2003) would have "qualified" her for less frequent paps by the
>> > recent Pap recommendations!
>>
>>I'll bet they wouldn't have been, but I agree with you.
>>
>> >
>> > The is reinforces my "just do 'em yearly" ... th eonly low risk patient
>> > being the virgin.
>> >
>> > Joanne
>> >
>> > --
>> > Joanne Bulley, MD
>> > Keene, NH, USA
>> >
>>
>>--
>>R. Daniel Braun
>> Kinky for Governor
>
--
I think I will do nothing for a long time but listen,
And accrue what I hear into myself...and let sounds
contribute toward me.
~walt whitman~
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