Endometrial Cells in PAP

I am 37 years old. Will be cancer free (Triple Negative Breast Cancer) for 3 years this June. I had double mastectomy as well as OOP (so I am postmenopausal). I still have my uterus.  For estrogen I had the ring (can't remember the name) for a few months and then switched to vagifem. I have had the vagifem for only a few months as well.

My pap last year detected HPV, but this year was normal, but this time endometrial cells were detected in my pap. I have no bleeding. My gynecologist wants me to have an endometrial biopsy.

How worried should I be that this is endometrial cancer?

Thanks.

[Elaine Brown, MD]

Hi!
If you were my patient, I would probably recommend a biopsy too, but think that the risk is low for cancer of the uterus.  (Unless you have one of the familial cancer syndromes.)
After the biopsy, you may want to discuss the possibility of progesterone with your gynecologist and oncologist.  It would significantly reduce your risk of endometrial cancer, but would probably not be worth using if it would increase your breast cancer risk. You could probably take it as few as four times per year to induce a period.
If you don't want children, you may want to have a hysterectomy to avoid the question altogether.  Since you haven't had the hysterectomy already, I rather suspect you want to keep your options open.  The risk benefit ratio is always the question in a case like yours.
Hope this helps!
Good luck!
Dr B