Hi guys, just a brief background, i went for my first smear test back in August and received results that i have mild changes so was booked in for colposcopy. when my doctor looked with the colposcopy he said that he could see mild changes but took a biopsy to confirm as apparently it was in a few different places. after this my mind was clear and i felt very reassured as my doctor basically confirmed that it was only mild changes.
i then went in for consultation of biopsy results where he told me that biopsy actually showed cin3. Also, I was pregnant at this point but had a termination after I received my results. I asked to be referred for a 2nd opinion and was given ‘one of the best’. So again, I went to see doctor no2 and she told me that because I was pregnant she’d like to perform smear + colposcopy + biopsy again as she said the pregnancy may have affected the results. She did biopsy and only took 2 whereas my previous doctor took around 6/7.
I got my results back today and the smear showed HPV high risk but no signs of cell changes and my biopsy showed cin1 and cin2.
So now I’m just confused as how can the 2nd smear and biopsy results differ so much from one another where they were taken less than 1 min apart. When I asked her she just said I don’t know, sometimes this happens. Not very helpful.
My first doctor had said that there is no evidence to suggest that being pregnant will affect results but my 2nd one disagrees.
My 2nd doctor has suggested I wait another 6 months and see what happens but i’m worried as I don’t know which result is accurate and which one to follow. Also, waiting another 6 months with this on my mind is going to be exhausting. I think whether it is cin 2 or 3 I’d want to have it treated as I’ve done a lot of research on potential side effects and the main one would be premature baby but that has a tiny risk so I’m not too worried about it.
Honestly, I’m just very confused as I don’t know how to proceed and even if I was to proceed which doctor I would do it with.
Hi Fi29 and welcome to our group.
I’m so sorry to read that you had to terminate your pregnancy because of your CIN3 result-that must have been incredibly difficult for you. And now your’e faced with all this confusion over your differing results, I can understand your uncertainty with everything.
I’m obviously not a doctor, but I am familiar with ladies whose results differed between the smear and biopsy and that seems to happen quite often. Smears are not always 100%reliable as a diagnostic tool, hence the need for the colposcopy and biopsies after active hpv is found. The smear is only a sweep of the cervix, and can miss things, so it’s the biopsies that give the definitive result. Your biopsies have shown CIN1 and 2, so that is the result that I would rely on as being accurate. You can have all levels of CIN in different areas of the cervix at the same time, with CIN1 not normally being treated.
Both CIN1 and 2 can regress naturally without any intervention, so the protocol is to “wait and see” and be tested again. I appreciate that this can be a worrying thing and waiting is hard, but this would be standard. Did you have treatment for the CIN3 cells when they were found? Typically treatment is done for CIN3 as they are the highest level of precancerous cell abnormality and much less likely to regress on their own.
You are correct in saying that risk surrounding treatment is very small, and were you to get pregnant after treatment, you would be closely monitored and have your cervix checked to see if there was any need to place a stitch in to avoid any issues.
I hope this has helped a little.
Sarah xx
Hi Sarah,
Thank you, it's okay to be honest I felt really pressured in my option of terminating my pregnancy, but whats done is done I can only look forward now.
No, I've had no treatment all I've had is 1st smear (showed HPV + mild changes) then had my colposcopy (looked only mild but doctor could see it in different places) and biopsy (cin2 and 3). I then asked for a second opinion where my new doctor repeated all the above so the new smear showed just HPV and biopsy showed cin 1 and 2.
I had to wait 6 weeks to have the other biopsy due to terminating my pregnancy so maybe both the cin 2 and 3 regressed to this. I'm not sure. My only worry is that maybe she didn't sample enough for the biopsy as previously my doctor had taken 7/8 whereas she only took 2.
Honestly, I think I'd like a 3rd opinion 
but I don't know where to go for one. As I'm worried if something was missed in this one and I still have cin3 and don't have treatment. I feel like both of my doctors (esp the 2nd one who was referred to me as being one of the best) haven't been very helpful to me and when I asked how dd the smear show this and biopsy show this she just said I don't know.
As I said I think I'd be most comfortable with going ahead with treatment as I just want it over and done with but as I said even if I was to do the treatment I don't know who I would have it done with.
Hi Fi29
I think with a decision to terminate, the issue can be that pregnancy hormones can affect the cells and make things worse as the pregnancy progresses so they don’t like to leave things. I’ve not read of CIN3 regressing without treatment, but as a non medic I can’t say it’s not possible. However, in a period of 6 weeks that might not be likely.
It’s clear you still have concerns, and I think in your shoes I would prefer to have the LLETZ treatment to remove all the abnormal cells to have some peace of mind about it all. It’s hard to say if enough biopsy samples were taken-I only had 2 biopsies taken but went straight to a cancer diagnosis.
You could try getting another opinion, and more biopsies if the new doctor decided that would be appropriate but maybe it would increase the confusion! However, if your most recent doctor wants to wait 6 months and you’re not happy with that, I would think it’s your only option to try with another doctor. It might be the same results as you’ve just had though. A difficult one for you.
Sarah xx
Hi Fi29
It makes it really difficult when even the specialists don’t agree, doesn’t it? We are relying on them to give us the accurate information we need to make the right decision for us.
I think your doctor wanting to see if it will regress on its own is definitely taking into account you’re so young-it becomes harder as you get older. I don’t think you’re silly at all wanting the best outcome for yourself, and if you’d be happier if you had another doctor brought into the picture, then you can do that.
I’m doing ok, thanks for asking-it’s been more than 5 years since my first cancer diagnosis and 4 years since it recurred. But I’m very glad to be here still!
Sarah xx
When they do the LLETZ, what they remove is sent to the lab for testing, both to make sure that the CIN level is confirmed, and that they have achieved “clear margins”. That means all the abnormal cells removed with an area of healthy tissue surrounding them to be sure they are gone completely.
I do get what you mean about wondering whether they have removed things completely with the treatment, but the LLETZ results would show that they had. If there are not clear margins, there may still be something there. In which case you would be checked again-sometimes the LLETZ does actually burn everything off and that will show up, but if it hasn’t been fully successful, it’s possible to have another one done.
All a worry though-I do get your concerns.
Sarah xx
Hi Fi29
The CIN level refers to the depth of thickness, so yes-CIN3 would require more to be removed as it goes deeper than CIN 1 or 2.
CIN3 is the full depth of the outer layer of the cervix, whereas CIN2 is two thirds.
Sarah xx
