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Pap Test Results
What do the results mean, and how should the patient be treated?
5
Medical
Professional
05/24/2012

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Term
Benign endometrial cells (BEC)
Definition
In premenopausal women, the shedding of these cells from the uterus lining is normal. But less than 2% of post-menopausal women will have this without a pathological condition.

An endometrial biopsy is recommended if the patient is over 40, has abnormal bleeding or spotting, or has risk factors for endometrial cancer (has family or personal history of ovarian, breast, colon or
endometrial cancer; obesity or tamoxifen (is an estrogen receptor antagonist used to treat breast cancer).
Term
Atypical squamous cells of undetermined significance (ASCUS)
Definition
This means that there are changes within the normal squamous cell pap smear. This is a somewhat vague diagnoses and can change from examiner to examiner. These changes are more than what is normal, but they fall short in number or quality of a squamous intraepithelial lesion diagnosis.

If the patient is over 30, she should have an HPV DNA test performed as HPV greatly increases the risk for cervical cancer. If it is found that she does have HPV, then we need to get a colposcopy to be sure that this isn't cancerous. If the results are negative, then continue with normal screenings.

If the patient is under 30, then an HPV test is not indicated as there can be too many false results. So repeat the pap at 6 and 12 months, and then resume routine paps if everything is normal. If any abnormal results came back, then get a colposcopy.
Term
Atypical squamous cells: cannot exclude high-grade squamous intraepithelial lesion (ASC-H)
Definition
This means that the examiner believes that there is a possibility that these cells were potentially a high grade lesion.

At this point it is important to get a colposcopic examination and a biopsy. If the biopsy comes back negative, it is recommended to get an HPV test.
Term
Low-grade squamous intraepithelial lesion (LGSIL)
Definition
In this diagnosis, there are abnormal squamous cells which are flat and scale like. They are fewer in number, with fewer changes. They are usually caused by infections or healing lesions. Less than 1% of women with this result will develop cervical cancer in the next 24 months. However, a colposcopy should still be performed.
Term
High grade squamous intraepithelial lesion (HGSIL)
Definition
These cells are very abnormal and are increased in number. While these raise a red flag for cancer, only about 1.5% will actually develop into cancer in the next 24 months.

It is important to get a Colposcopy with an endocervical curettage
(ECC) or loop electrosurgical excision
(LEEP).
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