A 45-year-old G1P1 presents for her routine annual examination. The patient is a healthy smoker who has no medical problems. Her surgical history is significant for a cesarean delivery with bilateral tubal interruption. You perform a Pap smear, which returns showing high grade squamous intraepithelial lesion (HSIL). She undergoes colposcopy, which is inadequate.
Cone biopsy of the cervix shows squamous cell cancer that has invaded only 2 mm beyond the basement membrane with a lateral spread of 5 mm. There are no confluent tongues of tumor, and there is no evidence of lymphatic or vascular invasion. The margins of the cone biopsy specimen are free of disease.
How should you stage this patient’s disease?
A. Microinvasive cancer, stage Ia2Stage Ia1, or microinvasive carcinoma of the cervix, includes lesions stromal invasion 3 mm or less in depth and 7 mm or less in horizontal spread, with no confluent tongues or lymphatic or vascular invasion. Stage Ia2 is stromal invasion more than 3 mm but less than 5 mm, and horizontal spread less than 7 mm.