WOMENS-HEALTH Messages for March, 1997: Re: carcinoma in-situ

Re: carcinoma in-situ

From: Efrain (anonymous@obgyn.net)
Fri, 7 Mar 1997 21:52:20 -0600 (CST)

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Your doctor is rigth. The new term for all pre-malignant lesions is low-grade or high grade squamous intraepithelial lesions. The key word to understand is intraepithelial,i.e. it is not cancer, it is within the"skin" that covers the cervix. Your CIN (cervical intraepithelial neoplasia) III is a HGSIL or CIS whatever you want to call it but, still pre-malignant.The Bethesda system combines moderate dysplasia with severe dysplasia and CIS into a single category (HSIL) for several reasons. First, separating moderate dysplasia from severe dysplasia and severe dysplasia from CIS has been shown to be irreproducible. Second, from a clinical standpoint, no useful purpose is served by this separation; moderate dysplasia is not usually managed differently from severe dysplasia and CIS. Third, combining moderate dysplasia with severe dysplasia and CIS will reduce discordance between the cytology and the biopsy reports by reducing the possible categories from three to one. Since the management of cervical lesions is based on correlation of the cytologic and histologic findings, greater concordance will reduce the morbidity, anxiety, and cost to the patient of repeated examinations. Now..what to do is another question.We have to take into account many variables. The treatment options are varied (LEEP,cryo, vaginal hysterectomy, etc. You should discuss with your doctor those options.

At Fri, 7 Mar 1997, Marissa wrote: >
>I was told by a doctor that carcinoma in situ is the same exact thing as
>CIN III, is this true? I was never told I had cancer, just dysplasia,
>until I looked at my medical records and discovered that the diagnosis
>code was for ca in situ. I was pretty stunned to say the least! Did
>this mean I had cancer or just dysplasia. I cannot find the answer to
>this question anywhere! I did do some research on the Internet and found
>the PAP smear classes chart and on that it says that carcinoma in situ
>is CIS, class IV; and that CIN III is dysplasia, a class III. In my
>records it states that I have CIN III and then it also says that
>carcinoma in situ was the diagnosis from the biopsy, I am really
>confused on this. How in the world could a person have CIN III and
>carcinoma in situ (a localized form of cancer..what I read.?) I would
>appreciate a prompt reply as I am experiecing much distress over this
>and I would like to be told what is going on ...Thank you very much!
>Marissa.
>
>--
>Marissa Gold
>

--
Efrain Ramirez MD FACOG

Next message: Robert Radnich,MD,FACOG: "Re: carcinoma in-situ"
Previous message: David: "Re: pelvimetry"
In reply to: Marissa: "carcinoma in-situ"
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