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Re: Gyn: Microinvasive Ca of Cervix From: Anna Meenan, MD (annam@uic.edu) Fri Apr 8 13:25:16 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: 34 week prom" Previous message: R. Daniel Braun: "Re: Granulation post hyst" In reply to: Joanne Bulley, MD: "Gyn: Microinvasive Ca of Cervix" Next in thread: Richard Chudacoff, MD: "Re: Microinvasive Ca of Cervix" Back in 98 I probably would have recommended colpo after the second ascus, since we weren't doing HPV testing then. If we had been doing HPV testing, she probably would have been positive for HPV in 95 and would have gotten colpo'd. I doubt her paps would have all been normal in 2000-2003. Extremely unlikely in this patient, so the possibility of Q 3-year paps would not likely have ever been an option for her. I am starting to get stuff from insurance companies regarding adhering to the new guidelines. I suggest you make sure your patients know they might get stuck with the bill for annual paps if they qualify for Q3-year paps. -- Anna Meenan, MD At Fri, 8 Apr 2005, Joanne Bulley, MD 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? > >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? > >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! > >The is reinforces my "just do 'em yearly" ... th eonly low risk patient >being the virgin. > >Joanne > >-- >Joanne Bulley, MD >Keene, NH, USA > Next message: Efrain Ramirez: "Re: 34 week prom" Previous message: R. Daniel Braun: "Re: Granulation post hyst" In reply to: Joanne Bulley, MD: "Gyn: Microinvasive Ca of Cervix" Next in thread: Richard Chudacoff, MD: "Re: Microinvasive Ca of Cervix"

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