How Accurate are Biopsies

johnT · Senior User Joined: 27 Apr 2009 Posts: 233

Posted on ProstateCancerInfolink is some scary information.
180 patients diagnosed with unilateral PC (one lobe) considering focal treatment (cryosurgery of HIFU) were given a 50 core 3D Mapping biopsy.
61% had bilateral PC, (PC in more than one place in both lobes)
20% had no PC detected.
22% upgraded to Gleason 7 or above.
In other words, 20% would have been overtreated, 22% may have been undertreated, and 61% would have failed focal therapy.
For patients just using biopsy results to choose a treatment option this is bad news.
JohnT
_________________
psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT

Jean222 · Senior User Joined: 14 Dec 2008 Posts: 261

Thanks for that information, John.

I sure wish I had found this forum with knowledgeable folk, a few years ago~~my Hubby might have had a fighting chance for a cure, had I known then what I know now. Sad

srtimmons · Posted: Fri Sep 18, 2009 4:09 pm Post subject: Biopsies

I have often wondered about the accuracy of biopsies and DRE results.

Very often the Gleason score is raied after the apthology reprt, for those electing surgery. And just beacuse the dRE is negitive, you might still have cancer. Thsi happended in my case.

Fortunately for me, the Gleason was not upgraded after surgery and, hopefully, I will not see a rise in PSA.

But those electing other treatment methods based on just a biopsy should be cautious.
_________________
Age 58
Dx 6/15/2009; PSA 7.1; 7/12 cores positive; Gleason 6 (3+3) and 7 (3+4); PNI observed. Bone Scan and CT scan negative.
Robotic RP 7/20/2009

Path report 8/11/2009 - clean margins, negative lymph nodes, negative seminal vesicles, Gleason 3+4, Stage T2c; 15% of prostate involved; NoMx.

PSA .006 September 2009
PSA .005 November 2009
PSA .005 February 2010

Operaman · Regular Joined: 01 Jun 2009 Posts: 25

I also note that there are a number of people on the forum including me that had a negative biopsy, when in fact we certainly had cancer at the time. Also my second biopsy, which was positive, under scored both my Gleason and staging. However, it saved my life, as the biopsy lead to the surgery. I now recommend that people use biopsy as a tool in the tool box rather than a single factor used in decision making.
_________________
Bioposy March 2008 negative
March 19 2009 4+3=7 PSA 26 positive for 6 out of 12 cores
RRP May 20 2009 Path 4+3=7 tertiary 5
5% Mostly right lobe some left
Stage T3a 1 focally positive margin, clean nodes, clean vesicle, all tests for mets clean
June 22 PSA undetectable,
course of Adjuvant RT completed in October with minor side effects
PSA 12/06/09 <0.05 (undetectable)

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