Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Cervical Cancer
Cancer of the uterine cervix (cervical cancer) is the second most common
malignancy in women worldwide. The widespread use of the Papanicolau test
(Pap smear) for screening purposes is responsible for the dramatic decrease
in the number of new cases of cervical cancer in the United States.
Approximately 10,000 new cases of invasive cervical cancer are diagnosed
every year in the United States and 1/3 (approximately 3,500) will die from
their disease. More than 50,000 cases of early cervical cancer (carcinoma in
situ) are also diagnosed each year in the United States. Even a larger number
of woman will have abnormalities detected in their screening Pap smear (see

Advanced cervical cancer is essentially a preventable disease. It’s
presentation as a precancerous lesion with a long-lead time gradually
progressing through predictable stages into invasive cancer makes this
cancer amenable to early detection and cure. In most cases, a premalignant
lesion (dysplastic cells) is identified in a Pap smear preparation that requires
further evaluation and diagnosis. Pap smears are classified according to the
Bethesda System and include:

  • Specimen adequacy
      o        Satisfactory for evaluation
      o        Unsatisfactory for evaluation
      o        Specimen rejected/not processed
      o        Specimen processed but unsatisfactory for evaluation
  • Interpretation/Result
      o        Negative for intraepithelial lesion or malignancy
      o        Epithelial squamous cell abnormalities
      o        Atypical squamous cells (ASC)
  • Atypical squamous cells of undetermined origin (ASCUS)
  • Atypical squamous cells (ASC) cannot exclude HSIL (ASC-H)
  • Atypical squamous cells (ASC) cannot exclude (LSIL)
      o        Low-grade squamous intraepithelial lesion (LSIL)
  • Human Papilomavirus/ mild dysplasia/cervical intraepithelial neoplasia
    (CIN) 1
      o         High-grade squamous intraepithelial lesion (HSIL)
  • Moderate and severe dysplasia, carcinoma in situ, CIN 2 and CIN 3
      o        Squamous cell carcinoma
      o        Glandular cell
  • Atypical glandular cells (AGC)
  • Atypical glandular cells, favor neoplastic
  • Endocervical adenocarcinoma
  • Adenocarcinoma
      o        Endometrial cells in a woman aged 40 years or older

Squamous cell carcinoma accounts for approximately 80% to 85% of cervical
cancers. The degree of differentiation of the cancerous cells correlates with
the prognosis of the disease. A well-differentiated large cell squamous cell
carcinoma has a better prognosis than a small cell undifferentiated squamous
cell carcinoma which is associated with a poor prognosis. Pure
adenocarcinomas of the cervix account for less than 20% of all cervical
cancers. Similar to squamous cell carcinoma, the less differentiated the
adenocarcinoma, the poorer the prognosis.

The degree of abnormalities detected on a Pap smear will determine the
intensity of required evaluation. Strong evidence implicates human
papillomaviruses (HPV) as a contributing factor in the malignant
transformation into cervical cancer. Workup of a woman with an abnormal Pap
smear includes:

  • HPV DNA testing
  • Colposcopy
  • Cervical (colposcopic) directed biopsies (if indicated)
  • Repeat Pap smear with colposcopy at regular intervals if untreated

Carcinoma in situ of the uterine cervix is known to precede the development
of invasive cervical cancer. Patients diagnosed with carcinoma in situ of the
uterine cervix that receive no treatment are known to progress to invasive
cancer in approximately 30% of cases over a 10 year period. Although
carcinoma in situ of the cervix can regress spontaneously, failure to provide
adequate evaluation and treatment to a patient with a carcinoma in situ of the
cervix is considered to be a clear departure from the acceptable standard of
care (negligence).

Treatment of cervical cancer varies according with the staging of the disease
at the time of diagnosis. For early invasive cervical cancer, surgery has
remained the treatment of choice (conization, total hysterectomy, radical
hysterectomy are accepted procedures). When the cervical cancer has
disseminated, radiation therapy (with  chemotherapy) represents the current
standard of care. Treatment of advanced cervical cancer requires a
multidisciplinary approach that includes gynecologic, radiation and medical

If you believe that you or your loved have been misdiagnosed or wrongly
treated for cervical cancer and suspect the injury may be the result of an
obstetrical or  gynecologic error that was diagnosable, avoidable and/or
preventable, you may have a valid cause of action. The injury may be the
result of a medical provider's mistake in handling your gynecologic condition
and the result of medical negligence.
Dr. Borten has over 35 years of
experience as an obstetrician and gynecologic surgeon to fully evaluate the
merits of your potential case. Allow the Boston area medical malpractice
attorneys at Gorovitz & Borten help you assert your rights and get the
compensation you deserve.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question
or concern.

Telephone:  781-890-9095     -     Fax:   781-890-9098
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