Cervical Cancer Risks: CIN-2 and Cone Biopsy Insights

Q: Cervical Cancer Risks: CIN-2 and Cone Biopsy Insights

Hello： 1. <br>The pathology reports from cervical conization surgeries mostly align with the pathology reports from colposcopic cervical biopsies, with a small portion being more severe and a very small percentage being less severe. <br>2. <br>Your current cervical biopsy report

Cervical cancer

Hello Doctor: I had a Pap smear in September this year, and the result was abnormal, indicating dysplasia that cannot exclude HSIL.
I subsequently underwent a biopsy, which showed focal CIN-2 in the uterus and cervix.
Microscopically, the sections reveal a picture of focal CIN-2-3 of the cervix with slight loss of polarity.
I took the report to a major hospital, and the doctor recommended a cone biopsy.
Could you please tell me if the results from the cone biopsy could directly indicate stage II or III, or even more severe conditions? Additionally, I experienced hematuria once in May/June, and after a urine test at the nephrology department, it was noted that there was some inflammation, but I have not had any further episodes of hematuria.
Could this be a symptom of cervical cancer?

Ting Ma, 30~39 year old female. Ask Date: 2007/10/04

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: 1.
The pathology reports from cervical conization surgeries mostly align with the pathology reports from colposcopic cervical biopsies, with a small portion being more severe and a very small percentage being less severe.
2.
Your current cervical biopsy report indicates CIN 2-3 (moderate to severe cervical dysplasia), making the suspicion of hematuria being related to cervical cancer less reasonable.
Hsinchu Hospital, Department of Obstetrics and Gynecology.

Reply Date: 2007/10/04

More Info

Understanding the risks associated with cervical cancer, particularly in the context of cervical intraepithelial neoplasia (CIN), is crucial for women’s health. CIN is categorized into three grades: CIN-1, CIN-2, and CIN-3, with CIN-2 indicating moderate dysplasia. Your concerns about the potential progression of CIN-2 to cervical cancer and the implications of a cone biopsy are valid and important to address.

Firstly, regarding the progression from CIN-2 to cervical cancer, it is essential to understand that not all cases of CIN-2 will progress to cancer. In fact, many women with CIN-2 may experience regression, especially with appropriate monitoring and treatment. The risk of progression to invasive cervical cancer is higher for CIN-3 compared to CIN-2, but it is still a gradual process that typically takes several years. Regular screenings and follow-ups are critical in managing these conditions effectively.

When a cone biopsy is performed, it is primarily to remove abnormal tissue from the cervix and to provide a more definitive diagnosis. The results of a cone biopsy can vary; they may show the same level of dysplasia as the initial biopsy, or in some cases, they may reveal a more severe condition. However, it is less common for the results to indicate a significantly less severe condition. The pathology report from the cone biopsy will provide a clearer picture of the extent of the disease and help guide further management.

As for your concern about the blood in your urine, it is unlikely that this is directly related to cervical cancer. Blood in the urine (hematuria) can arise from various causes, including urinary tract infections, kidney stones, or other renal issues. Since you mentioned that a urologist found some inflammation but no ongoing issues, it is reasonable to consider this as a separate concern from your cervical health. However, if you experience any further symptoms or if the hematuria recurs, it is advisable to seek medical attention promptly.

In terms of treatment options, if your healthcare provider has recommended a cone biopsy, it is likely because they believe it is the best course of action to manage your CIN-2 diagnosis. This procedure not only helps in diagnosing the extent of the abnormal cells but also serves as a treatment to remove potentially precancerous tissue. If you are concerned about fertility or future pregnancies, it is important to discuss these issues with your healthcare provider. Many women can conceive and have healthy pregnancies after a cone biopsy, but individual circumstances can vary.

In summary, while the diagnosis of CIN-2 can be concerning, it is manageable with appropriate medical care. Regular follow-ups, including Pap smears and HPV testing, are essential in monitoring your cervical health. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and support. Your health and peace of mind are paramount, and staying informed is a key part of managing your health effectively.

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