WOMENS-HEALTH Messages for August, 2002: Re: LEEP With Positive Margins Inquiry

Re: LEEP With Positive Margins Inquiry

From: Samir Fouad Aziz MD (anonymous@obgyn.net)
Mon, 12 Aug 2002 15:14:46 -0500 (CDT)

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In reply to: Maria: "LEEP With Positive Margins Inquiry"

At Mon, 12 Aug 2002, Maria wrote: >
>Hello- I have a question about positive margins after a LEEP procedure
>for a diagnosis of carcinoma in situ. My pathology came back CIN 3 all
>the way to the cut margins of my LEEP specimen. My dr has assured me
>that after cauterizing, any residual CIN would have been destroyed. This
>is my question: what if it wasn't? What is the natural progression of
>carcinoma in situ of the cervix that has been left behind after a LEEP?
>Does it progress to invasive cancer? And it is my understanding that
>once cells reach the CIS stage, they no longer act like regular cells,
>meaning they no longer shed inward/outward. So does that mean that a
>pap smear will never detect this lingering CIS? Therefore, would it only
>become known until after it progresses to an invasive cancer and
>symptoms present?
>
>Thank you.

there is reports about regression of CIN after biopsies of cervix explained by increased local immunity of the cervix,These reports were about CINI-II and follow-up was for years. however progression to invasive cancer should be considered seriously,which may takes 2years for CIS to progress to invasive cancer. Pap smear will detect any abnormal cells, however It is advisable to have repeat pap smear and colposcpy together within 3 months and if still positive have another LEEP or hysterectomy if you do not consider to be pregnant anymore.

-- Samir Fouad Aziz Asist.Professor OB.Gyn Al-Azhar University-Egypt Editorial Advisor Obgyn.,Pregnancy & birth and Gyn.oncology

this is for educational purposes only.

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