Inaccurate biopsy results.

User

Posted 07 Jan 2025 at 11:07

I believe that an accurate Gleason score is unlikely to increase. However, unfortunately biopsies can miss more aggressive cancer cells.I think this is what happened in my case.

Four years ago, following a TRUS, 14 core, biopsy. I was diagnosed Gleason 6 (3+3), T2a disease. Less than two years later, a follow up, transperineal biopsy under GA, showed disease progression, there were areas of Gleason 7 (3+4), 7(4+3) and 8 (3+5), T3a. I had a prostatectomy which showed Gleason 9 (4+5)

I was rather bewildered about the huge variation in the Gleason scores.

I have learnt that biopsies, although they are the best we've got, are not as reliable as we may expect and the results are open to interpretation.

I've just found this information. Which some may find interesting.

https://www.rcpath.org/profession/publications/college-bulletin/october-2021/prostate-biopsy-reporting-the-case-for-a-pragmatic-approach.html

User

Posted 07 Jan 2025 at 17:12

Hi Adrian,

That looks an interesting paper although a bit long at the moment. I was diagnosed as 4+3 but after surgery it became 4+4. Hardly suprising as the biopsy sample was very small, one pin bad out of 12 taken. Although 3 were lost or no sample.

From what you see, the cell structure varies from almost normal Gleason 3, to very changed at 5. I'd imagine that it wouldn't be too difficult for one sample to be interpreted differently by two different people. Also how is it decided when it's all 4 or what size of 3 makes it 4+3.

I'll have a look at the paper at some point, although I'm not expecting a biopsy, although never say never.

Cheers Peter

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.

Notification

Inaccurate biopsy results.

Join the online community now.