Hello, I have been going threw this since 2006 when I got my first abnormal pap which was LGSIL and it stayed the same until Dec 2009 and it is now ASCUS-H. I have had 3 cervical colposcopys and a full vaginal colposcopy and I had a LEEP in Feb but all margins were negative. Now my doctor wants me to repeat my pap in June and she''s going to refer me to an oncologist. Why can they not find this spot? Where could it be and could it be invasive? I hope someone can give me an answer...
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replied May 7th, 2010
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I have had LEEPS as well, I need to explain to you that the margins being negative DOES NOT mean they have "not found it". When the path report reads "margins negative (clean margins)", that means that the borders of the biopsy they took from you showed no sign of HSIL/LSIL/ASCUS, not that the whole biopsy was negative.

Did your doctor say that the biopsies themselves were negative? Or just that the margins were clean? Is your doctor referring you to an oncologist because the biopsy itself (remember, not the margins, which are the borders around the biopsy)showed an abnormality? Or are you being sent to an oncologist because they found no sign on the biopsy or the margins of any type of abnormality?

It is normal to have a repeat Pap every 3-4 months for a year after having a colposcopy.


To answer your question "why haven't they found the spot?"...ASCUS AND LSIL both can go away by themselves. They are NOT cancerous BUT CAN BE signs of precancer.

ASCUS-H just means that you have atypical squamous cervical cells and they cannot rule out a precancerous lesion. This does NOT mean that they will FIND a lesion, just that they cannot rule one out. The good news is that they have not found a lesion. You should also, if it has not been done, have an HPV DNA test done on your biopsies, as this will help your oncologist determine the best route of diagnosis and treatment.

There are other factors that can cause ASCUS and LSIL...age is a big factor, as is trauma to the cervix. If you are post-menopausal, the natural thinning and drying of your cervical tissue (due to menopause) can cause them to appear abnormal on a PAP/biopsy. Women who have recently vaginally delivered babies can have what appear to be abnormal changes on a PAP/Biopsy due to the healing of the cervical tissue.

You need to speak with your doctor and get your questions cleared up. If you feel your doctor is not doing right by you, ask for a second opinion...second opinions never hurt. I hope I have been of some help to you.
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replied May 7th, 2010
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I forgot to add that the reason that the margins need to be negative is to make sure that when they did the biopsy, they got the entire lesion. Clear margins just means that the border around the biopsy is clean, which means they got the entire lesion.

Did your doctor explain the LEEP/Colposcopy procedure to you? If not, here goes:
Basically when they did the colpo on you, they used a vinegar/iodine solution inside of your vagina and on your cervix. When this solution hits abnormal cells, it makes the area of the cervix affected turn white. The doctor would have seen this and known exactly where to biopsy. They remove (or should have removed) all of the white areas for biopsy. As long as this was done, then they did "get it". Now, whether or not you actually had precancerous cells is a totally different thing, as I explained in my previous post. Sometimes ASCUS-H and LSIL are just that and go away by themselves. Usually LSIL/ASCUS (in about 70% of women) turns out to be nothing, however they will do colposcopies on women with LSIL/ASCUS just to make sure. Keep your appointments! Best of luck.
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replied May 20th, 2010
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Hi, you mentioned that 70% of ASCUS goes away by itself. I did not know that. I had a pap smear and it came back 'ASCUS.' I have read that things varying from sex to tampons being used slightly before the pap smear could be causes for the ASCUS. But, I know I hadn't used a tampon in several weeks and I just can't remember if my partner and I had sex the day before. I am scheduled next week to go in for the colposcopy. I am scared to death. I have routine (annual) pap smears but I am reading all about HPV, cancer, etc. I am driving myself crazy. I know this is a stupid question, but is it true that 70% (most?) cases of ASCUS turn out to truly be nothing? Thank you for any help you can provide.
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replied May 20th, 2010
Hello ladies, I apologize for not checking in sooner and replying to the posts. All of my biopsies have came back normal, including the LEEP. I am going in for a laproscopy tomorrow because he thinks I have endometreosis. I wonder if that could cause my paps to be abnormal?? He said if I do have endo. then he'll give me a hysterectomy because he thinks that I have had enough female problems and I totally agree with him! I wish he would do it tomorrow! When I go in for my 6 week checkup he's going to do another pap and if that one comes back abnormal then he'll schedual the hysterectomy. I have constant lower back pain and cramps, and bleeding and pain with sex. Oh, the joys of being a woman,lol.
Yes, a lot of women are able to get rid of the hpv without any treatment. Almost all women have been affected with hpv and don't even know because thier bodies get rid of it. I think the internet scares the crap out of a lot of people, I know it has me! I always say that I need to be banned from the internet because I read scary stuff and then I start acting like a madwoman,lol. I have decided that fear does nothing for me so I gave up on the internet stories (that's why I haven't been on here) but I do thank you for your posts and your information. It definatly made me feel better! Please pardon my poor spelling,lol.
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replied May 24th, 2010
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I am glad to hear they found no naughty cells. Sorry to hear about your endometriosis...that is a pain (speaking from experience). If you want the hysterectomy, I say go for it! Good luck and hope all is well.
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