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LLETZ treatment for CIN3 - clear margins?

mia426
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Hello there, I recently have a Lleptz treatment for my cervix. Today, I received a letter from my doctor saying "This showed the presence of severe pre-cancerous changes (CIN3). Fortunately nothing worse was found and the treatment that you had should have dealt with this problem for you". I wonder what that means? Does that mean I do not have normal cells in my cervix anymore (including Cin1, 2 and 3)? Do I have clear margins? Is there a pathology report?

I am new to the U.K and have no experience dealing with the NHS system. I am very anxious as I am only 30 and really want to have kids in the future. It has been a stressful few months. Could you please help if you have a similar experience?

 

  • Hello and thank you for your post,

    It is difficult for me or anyone here to be certain about this but it does look like all the abnormal area (CIN3 ) was removed.   I think to clarify this for you, you should either get in touch with your GP (family doctor) who is likely to have these results and may also have details of the pathology report. He or she may be able to tell you about your surgical margins.  You could also try giving the colposcopy unit a call and ask to speak with a nurse, who can see your medical notes, about the letter and explain what it means.

    I do think that if your margins were not clear that you would be asked to go back to have further treatment.

    Having cells on your cervix removed will not affect the vast majority of women to have a baby. It can only possibly affect a future pregnancy if a woman has had multiple treatments to have abnormal cells removed or a lot of tissue removed. It is not usually a problem after having a LETTZ procedure. We have more information about this and what can be done if it is a problem on our website, it particularly gives information about the LLETZ procedure (scroll down the page), you can see it all here 

    I hope you can get this sorted out and that you will be okay.

    Take care,

    Caroline

  • Offline in reply to CRUK Nurse Caroline

    Hi Caroline, thank you so much for your reply! I just got some more information in an email:

    1. The depth of the excision was 10 mm so this is unlikely to have any effect on future pregnancies

    2.  specimen contained CIN3 only, no CIN1, no CIN2 and no cancer. The CIN3 reached the lateral/ectocervical margins but this has minimal if any effect on cure rates, so we would expect your HPV test to be negative when you have it repeated with us in 6 months. 

    I wonder what "CIN3 reached the lateral/ectocervical margins", does that means I do not have a clear surgical margin?

     

    Thank you!!

     

  • Offline in reply to mia426

    Hi and thanks for posting again

    I can imagine it was reassuring to know that there were no signs of any cancerous cells from the biopsy and that it also would not have an effect on future pregnancies.

    It doesn't necessarily sound like there was any problem with margins and I'll try and explain. When you do a smear test, the brush goes into the cervical os (the opening in the cervix that goes into the cervical canal)taking in cells that line the outside of the cervix(called the ectocervix) as well as going into the cervical canal(called the endocervix)

    It sounds from the report that the cin3 may have gone from inside the cervix as far as to the outer margins of it. It says though that this has a minimal effect on cure rates so do be reassured by this. A smear is always taken 6 months after treatment to make sure that there are no longer any changes in the cells and that the HPV has gone.

    We are nurses and so do not usually read or interpret pathology reports, so it would be best to discuss this with the GP who will also have received the report ,or colposcopy clinic who will have all your medical details to hand.

    Try and not overthink this as if here was any doubt about margins, I'm sure you would have been called back.

    All the best

    Wanda

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