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Biopsy results

Joditd
Posts: 17
Joined: Feb 2018
Joditd
Posts: 17
Joined: Feb 2018

so my biopsy results came back benign. You all encouraged me to ask for a D&C which I did when I went for the saline ultrasound. He told me that I didn’t need one. That being said, he also said my issues were hormonal, whereas the PA I initially saw said they were not hormonal and due to a polyp. He said my estrogen levels would be ”through the roof.” The nurse today said he hasn’t reviewed my blood work but would call back once reviewed. I asked her what they were. Estradiol was 226 (they did note a folical on my L ovary during the US). Estrogen was 0.39. I researched and see that the estradiol is normal for where it should be in the cycle. I can’t find anything on the estrogen. So far I feel like what he told me isn’t consistent with my estrogen being “through the roof.”  And why would they see a “polyp” on the initial US they did when I was bleeding so heavily and see nothing on the saline US two weeks later? So do I accept the results and just move on and hope I don’t have another 25 days of bleeding heavily, no explanation for the watery discharge and difficuly urinating OR should I get a second opinion? Can anyone interpret that estrogen level? I’m sorry if I’m a pain posting here when my biopsy was benign. I don’t want to step out of line where I don’t belong. I think you ladies have the experience I don’t have to help point me in the right direction. 

MugsBugs
Posts: 110
Joined: Jan 2018

I am different because I am postmenopausal but I still would feel better if you had the D&C.  My biopsy came back as 'pre-cancer' so they sent me for a ultrasound. The biopsy isn't perfect because they are taking a random sample and might not get the right location. The ultrasound found nothing but some fibroids.  I would have been happy to let it drop after the ultrasound but my doctor insisted on doing a D&C with Hysterscopy.  She saw several places that were suspect and did scrapings that turned out to be cancer.  I had a complete hysterectomy on January 29th and got my pathology report today and I am cancer-free.  My oncologist said that I have 1% chance of recurrence.  If I had said 'yahoo' after the ultrasound (which is actually what I did - I am kind of a wimp) and we had not done the D&C the cancer would still be there.  My paperwork today said "Endometrial Cancer" - my Oncologist said today when I see him next my paperwork will say "History of Endometrial Cancer".

The chances are that your doctor is right that it is nothing but I think the D&C is more definitive and will give you peace of mind - which is important.  

I never had an estrogen level done - probably because I was postmenopausal so the younger ladies can help you with that.  

Good luck and keep us informed!

Tamlen's picture
Tamlen
Posts: 207
Joined: Jan 2018

I don't know if this is helpful, but in since I've joined this journey (as of December), I've learned that some doctors parse their words in ways that can be a problem. It is worth pushing for clarity and if you can't get it, find another doctor.

My PCP sent me for an ultrasound, which found a 2cm mass in my uterus. After an in-office biopsy with my new gyn (my old one had retired) went badly awry, she did a D&C. When I met with her to go over the results and the path report, I asked her to draw the location of the mass. She replied, "I didn't see any mass at all." I was surprised, since a 1-inch mass isn't tiny. I said, "There was no mass?" She replied, "It was probably just a clot moving through." That gave me such relief.

But it shouldn't have. When I met with my new gyn/onc several weeks later, she mentioned a 1" mass. Both my husband and I were shocked and it was such a rollercoaster moment, hopes dashed. Now there was a mass? The gyn/onc had looked at the ultrasound and said it was a clear mass in the uterine wall (confirmed in my hysterectomy last week). I repeated to the gyn/onc what this gyn had told me and the gyn/onc said, "Well, it was true she didn't see it, as it's in the wall of the uterus, but I have no idea why she'd say it that way."

I concur with the others that you're entitled to clarity and a doctor with the patience to answer the questions weighing on your mind. There's enough to deal with without the worry of wondering if your doc is in your corner.

derMaus's picture
derMaus
Posts: 561
Joined: Nov 2016

You're not a pain for posting and asking questions about your symptoms, banish the thought. You are a RN so I'm wouldn't presume on medical knowledge, but you do have many of the same symptoms I did and a biopsy takes only a small piece of the whole, so I would want more information if I were you. My symptoms were consistent with perimenopause, which runs late in our family, so I wasn't alarmed - nor were any doctors I consulted. Thanks to that, I would up Stage III at diagnosis. I say that not to frighten you but because I'm surprised that your doc isn't doing more follow-up. Have you had a CA 125? My estrogen wasn't the problem, the cancer was, but many of the symptoms overlapped thus were dismissed. When they say the endometrium is think how thick do they mean? I'd certainly find another doc who takes your situation more seriously; it doesn't sound like this one is. Either way you deserve complete and satisfying answers, not 'it's hormonal'. 

Joditd
Posts: 17
Joined: Feb 2018

Thank you!  I feel like I am being such a pain.  When he came in saying I wasn't ovulating right away before he ever even did the exam or bloodwork I was a little taken aback.  Especially after the PA said it was anatomical, which was why the birth control pills weren't helping to stop the bleeding.  My gut tells me that I should probably either push with him for more testing or find another doctor for a second opinion, but it's hard to think without letting emotions get in the way when it's about yourself or your family.  It's easier to be objective when it isn't yourself.  I am just an LVN not an RN, so I don't know quite as much and I work peds so the hormone levels aren't in my field of expertise, unfortunately.  I guess i can see what he says when he eventually calls me with my lab results and go from there.

txtrisha55's picture
txtrisha55
Posts: 685
Joined: Apr 2011

Get a secnd opinion from another3r dr.  If it is the same as the first and you still feel like something is not right get a third. Y ou have to be your own advocate.   It is your body, pay attention to it.

HorseLvr's picture
HorseLvr
Posts: 102
Joined: Nov 2017

If you are able to get a second opinion (if your insurance covers it or you can afford it if it isn't covered), by all means, do that. You will then have peace of mind that you did all you could. Has the doctor suggested a way to stop the bleeding?

I'm surprised that people are saying the biopsy only  takes from specific areas. Do they not do pipelle sampling in the States? My ob/gyn says the pipelle goes all around the endometrium "like a roto rooter" and takes a sample from the whole thing. He says D&C is rarely done anymore.

CheeseQueen57's picture
CheeseQueen57
Posts: 821
Joined: Feb 2016

I question why they even do endometrial biopsies. They hurt like hell. In post menopausal women the cervix is often so closed that they can’t get an ample sample. My results were negative but stated the sample size was probably not enough. D&C indicated cancer and hysterectomy showed Stage 3c, Grade 3. 

HorseLvr's picture
HorseLvr
Posts: 102
Joined: Nov 2017

That concerns me about the cervix. I've also read that if you've had an edometrial ablation, the cervix can close, as well as with a cone biopsy. I've had both plus I'm in menopause so that's a triple whammy against me. I wish I had asked my dr about that. 

MugsBugs
Posts: 110
Joined: Jan 2018

That was my experience with the biopsy. It hurt bit wasn’t  excruciating. He said the second snip would be 10 seconds and I remember asking ‘How much longer?’.  My regular gyno was the one who insisted on the D&C with hystscopy because she said that the biopsy is random and may not biopsy he right spot.  She did the D&C and scrapped where she saw ‘calcifications’.  My surgeon/oncologist said she scrapped all the cancer away because all they found were precancerous cells after the hysterectomy.  The hysterscopy allows them to really see what is there.   

Joditd
Posts: 17
Joined: Feb 2018

I have no idea about the biopsy.  It felt like a pinch twice, very quickly when he did it.  He suggested I take progesterone for half of the month, because he thinks I am not ovulating due to high estrogen levels.  That was the only suggestion for the bleeding.  If the estrogen levels aren't high like he thought, then I am not sure what he will suggest.  Maybe the 0.39 estrogen level is actually high.  I don't have paramaters for what that lab should be.  I just know the estradiol is WNL of where I was in the cycle when the blood was drawn.  My weight has increased to around 200 lbs, and I am 5'6, so he thinks my weight gain was the initial contributing factor from what I gathered.

 

txtrisha55's picture
txtrisha55
Posts: 685
Joined: Apr 2011

What type of dr is he?  Is he just a regular dr or a oby gen dr?  Telling a woman that her weight is why she is bleeding is not right.  There can be many reasons.  Find another dr and get a second opinion. Wishing you luck. trish

lucindaw's picture
lucindaw
Posts: 3
Joined: Feb 2018

The reason for the estrogen concern is that adenocarcinoma type of cancer can develop in your uterus and it feeds off your estrogen.  I had Polycystic Ovarian Syndrome which is basically a hormone imbalance which cause problems for your periods and gives you heavier then normal bleeding or very light to no bleeding unnbearable cramps causes cysts to form on your ovaries which can be very painful.  I am not sure if you have PCOS but I agree with others on here you should get a second opinion.  

HorseLvr's picture
HorseLvr
Posts: 102
Joined: Nov 2017

Fat cells produce estrogen. Fat people are more likely to have high estrogen levels. That could be what her doctor was referring to. I'm a fat chick who's been through menopause, yet I have an 8mm endometrium and it should be under 5. That's because I still produce estrogen. 

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