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abnormal pap showing abnormal endometrial cells
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Nrsepat1957 posted:
I have a history from 2 years ago of endometrial cancer. It was considered stage 1 grade 1. They did not do a hysterectomy, and did 5 HD brachytherapy radiation treatments. Since then my Paps have been normal until this last one 2 weeks ago. The NP said that it showed abnormal endometrial cells. They were not cancerous. I had an internal Ultrasound 2 months ago of the uterus and it showed nothing abnormal. What questions should I ask the Oncologist when I go for my appointment, and what testing should I have done. Thank you,NrsePat1957
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Anon_6061 responded:
I'm glad to hear that your cancer was cured with radiation and you didn't need to have a hysterectomy! It doesn't seem that this option is even offered most of the time.

I don't have any input as far as what to ask the oncologist except to possibly have another pap in a few months since abnormal cells can be an indication of something benign and transient. Granted, with your history you need to be extra vigilant but need to also consider effects of overtreatment. Here are a couple of links that may be helpful -
Understanding cervical changes - http://www.cancer.gov/cancertopics/understandingcervicalchanges
Pap and HPV testing - http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing

Let us know the outcome of your appointment.
 
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Jane Harrison Hohner, RN, RNP responded:
Dear NrsePat: As you likely know, PAP smears screen for squamous (cervical epithelial skin cells) cells and glandular (similar to endometrial cells) cells which line the cervical canal. My best GUESS is that you may have had an AGUS (atypical glandular cells of undetermined significance) PAP result. Here is a more detailed discussion of AGUS:

http://www.aafp.org/afp/2001/0601/p2239.html

NrsePat, it is also possible to have to have actual endometrial cells which have floated down the cervical canal. They are then found on a routine screening PAP. The good news is that the cells were apparently dysplasia/abnormal rather than neoplasia/cancer.

Once the oncologist has your PAP report in hand they can give you the most "for sure" answer. In terms of additional testing, a lot will depend upon the actual origin of the suspicious cells and the severity of any abnormal cells. An endometrial biopsy ("EmBx") with an endocervical currettage (also known as an" ECC") MIGHT be suggested. This would examine both areas from which glandular cells can arise. Your GYN oncologist will have the best idea on how to re-screen.

If you would be so kind, would you let us know what you find out. Your experience could be helpful to other women who find your excellent post via the clearly stated subject line.

In Gratitude,
Jane