• issues with pap smear....

    Asked by Debbie on Saturday, May 4, 2013

    issues with pap smear....

    My gyn's office called yesterday afternoon to tell me my pap smear results are abnormal (hpv negative). Of course he's out of the office until Monday. I've never had this before and it is scaring me. Has anyone else dealt with this after completing breast cancer chemo and radiation?

    5 Answers from the Community

    5 answers
    • kickasscowgirl's Avatar

      Hi Debbie,
      Isn't it awful when you get those calls on a Friday!! It's good info to know when you're being treated for cancer, but would be nice if you could have more answers right away. I'm finding that it takes a lot of patience going through the breast cancer treatment process. I have to tell myself to stop feeling like I always need an immediate answer, because it helps me not have my day or weekend ruined by wondering how significant something is or isn't!!! I bet you can relate to that! It is scary, but it's manageable.

      Any 'abnormal' result will need follow up so you'll definitely get answers soon. Any of us could be carrying hpv without knowing it. Its a very common virus. We all carry many virus strains without them ever becoming active. Getting hpv would only take one sexual contact in our lifetime to contract, and like any virus could be dormant and people wouldn't know they have it or pass it on. There is a link between hpv and cervical cancers, so it's good treatment that you got your pap done.

      I haven't had that same thing, and this is in my words, not the dr's, but it was explained that chemo treatment can bring out, or bring to the surface minor other issues that involve rapid cell growth. Or maybe anything to do with stress and lowering our immune system can bring things to the surface during and after chemo.

      I had something act up on my skin and it came out during chemo maybe because it was a spot of skin cancer and the chemo was killing it. And it went away. I also realized at that time that I am becoming hyper-vigilant about everything with my body now. From wanting to get well and wondering what new side effect, what else...etc, etc... You can google key words from your results, like "abnormal pap smear" or "hpv negative" and read to get general information, but be careful not to think that everything you read could be the problem! ha ha add to anxiety! Make it a tool to help you know more exactly what you want to ask when you do talk to your gyn. That helps me a lot when I see my oncologist. I also have a great chemo nurse that welcomed calls about any kind of questions even if it didn't seem directly about chemo. Best Wishes... enjoy your weekend, time is valuable, right? {{ Hug }} Gigi

      over 3 years ago
    • carm's Avatar

      I am an oncology nurse who specializes in gyne cancers. This is a sheet i give my patients and maybe it might also help you. Best of luck to you, Carm RN.


      ASCUS (Atypical Cells of Undetermined Significance)
      This definition signifies that your cervix contains atypical squamous cells that the pathologist is not 100% sure is due to a benign process.
      Recommendation...3 follow-up options:
      1-Repeat Pap Smear in 4-6 months
      2-Perform an HPV test ("reflective HPV test" automatically with ASCUS diagnosis)
      3-Undergo Colposcopy
      ASCUS-H (Atypical Cells of Undetermined Significance-Cannot Exclude High-Grade Intraepithelial Lesion)
      Further catagorized as "ASCUS favor HSIL" or "ASCUS, cannot rule out HSIL."
      These diagnoses tell the clinician that the pathologist is very concerned that the atypical cells she is seeing may be coming from HSIL. In fact, a large percentage of women with this diagnosis will prove to have an HSIL, somewhere around 40%.
      Recommendation-Colposcopy and biopsy of any worrisome areas. HPV is not recommended in this instance because we know that the vast majority (over 80%) of women with ASCUS, favor HSIL pap results will have a positive HPV test.
      SIL (Squamous Intraepithelial Lesion)
      A diagnosis of either LSIL (L=Low-grade) or HSIL (H=High grade) on a pap smear indicates that the cells present on the pap smear have come from a precancerous lesion, either low-grade or high-grade.
      Recommendation-Colposcopy and biopsy of the cervix. The difference between cervical biopsy and pap smear is that a pap samples cells on the surface of the cervix. A biopsy is a "mini-excision" of a tiny portion of intact tissue that allows the pathologist to see a cross section of the entire depth of the cervical lining. A definitive diagnosis cannot be made until a biopsy has confirmed the pap smear diagnosis.
      LSIS (Low-Grade Squamous Intraepithelial Lesion)
      For LSIL diagnoses, the 2007 ASCCP guidelines for most women recommend cervical colposcopy followed by a biopsy of any visible lesions. There is a sensible rationale behind recommendation. We know that a significant number of women with LSIL on their pap smears will later prove by biopsy to have an HSIL, the most worrisome lesion for persistence and cervical cancer. As an interesting note, it seems that just the act of cutting into the cervix seems to speed up the disappearance of an LSIL. It is thought that the trauma to the cervix may stimulate a womans immune system to rid itself of the lesion at a faster rate!
      Post menopausal women are unique in that they can sometimes have abnormal pap smears that look very much like dysplasia but reflect non-HPV related changes called "Postmenopausal Atypia" for which they don't need treatment. This atypia may disappear on subsequent pap smears.
      HSIL (High-Grade Squamous Intraepithelial Lesion)
      Recommendation-confirmation by colposcopy, tissue biopsy, followed by removal of loop procedure (Loop Electrosurgical Excision Procedure-LEEP). HSIL diagnosed on the cervical biopsy tissue can be divided into two levels of severity: Moderate dysplasia and Severe dysplasia. "Watchful Waiting" recommended for moderate dysplasia in adolescent females, excision with severe dysplasia.
      AGUS (Atypical Glandular Cells of Undetermined Significance)
      "Atypical glandular cells, not otherwise specified" can be either endocervical or endometrial cells.
      Recommendation for endometrial cells-Endometrial biopsy
      Reccomendation for endocervical cells-Endocervical curettage, sometimes biopsy. If from endocervix, then the concern is that you have adenocarcinoma in situ (AIS). Two types of diagnosis-AGUS, or AGUS, favor neoplastic.
      AIS (Adenocarcinoma in Situ)
      This diagnosis signifies a definite endocervical precancerous lesion related to HPV infection.
      Recommendation-Loop Procedure or Cone Biopsy (Cold Knife Cone).
      Squamous Cell Carcinoma and Adenocarcinoma
      Invasive cancers no longer restricted to the cervical surface lining cells but have invaded into the underlying tissue. By invading, these tumors now have the ability to metastasize elsewhere in the body.
      Inflammation of the Cervix.

      over 3 years ago
    • hogfan03's Avatar

      Hang in there Debbie! I know it is scary and frustrating, especially when you are told on a Friday. I dont have the answers you are looking for but i understand what your feeling. Three days after I was diagnosed with cervical cancer, I was told my mammogram showed something and I had to come back in for an ultrasound. I had a needle biopsy later that week on a Friday and was told I might have results over the weekend which of course did not happen. I know the stress you are going thru! Fortunately my results came back negative for breast cancer. As kickasscowgirl said you will go back to the gyn dr to discuss the results and maybe it is from the chemo I will keep my thoughts and prayers that the abnormal pap is nothing to worry about!

      over 3 years ago
    • derbygirl's Avatar

      Hi Debbie. As a clinical assistant in an OBGYN office, I can certainly understand your reaction to getting those results. Try to relax because there are many women, including myself that have been told they have abnormal pap results. Depending on your doctor, there are several things that can be done. First he can do a repeat pap in 3-6 months and at the same time he can order an HPV screen by checking off a box on the lab slip. The second thing is to simply do an HPV screen which is the same procedure as doing a pap. The other choice he has is to do a colposcopy which can be done in the office and gives him the opportunity to check for abnormal cells using a colposcope to view the inside of the cervix. Try not to worry about your results because there are many reasons why they could have come back abnormal. If you have questions about the way a colposcopy is done, send me a message and I'll go over it step by step for you. Take care.

      over 3 years ago
    • SueRae1's Avatar

      Don't you just love it when they drop a mini bomb and then are not available to discuss the implications. I think he should have taken the time to talk you about the results, or waited until he could do so. I have had several abnormal smears none of which turned out to be anything when further testing was done. I would call your gyn's office first thing Monday and ask to speak to him and find out what is going on. I was also let him and his office know that you calling you with the results and not being available to discuss them right away very unprofessional and that you expect your medical team to be sensitive and collaborative in treating you.

      over 3 years ago

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