needle biopsy vs final prostate patholgy

[larry9002]

I had robotic prostate surgery in July. Going into surgery, I had a 12 needle biopsy. One of the needle cores tested positive for cancer. Of this one positive needle sample, 1/5 of it was deemed cancerous. My Gleason score was 3 plus 4 for a 7 total. My surgeon informed me that the final pathological exam of my removed prostate showed that the cancer was present in 42% of the gland and that retrospectively it was good that I found the cancer when I did and had it removed. I went on-line looking for comments regarding the reconciling of final pathology with the initial needle core biopsies. I found that this discrepancy is not uncommon and that Gleason scores are often off by a full point. It seems like common information is that this cancer is very slow growing and that we have lots of time to make a decision. You rarely find information that speaks to this "common discrepancy". I only looked for it from a backwards angle and before hand had no idea to research such a statistic. I plugged into my browser the following, "reconciling final prostate patholgy with initial needle biopsy". Several articles appeared and they were quite scholarly. This was never spoken to me by two surgeons and a radiation oncologist, nor did I find discussion of this in many essays that I read while educating myself beforehand. Maybe the whole idea of "taking time" is overstated. Looking for your comments.

[purelife53]

Pretty common I've heard and experienced as well. Mine went from a Gleason #7 after the biopsy, then the 2nd opinion of the slides rated it as a #6 Gleason pre op, then after the radical prostatectomy the Gleason. score came back a  very aggressive # 8. Almost 3 months passede from the needle biopsy until the surgery.......makes one think it advanced during the "delay".

[tlee6565]

I think it is one of the benefits of surgery..over radiation.. i had the surgery in late june of this year..  age 55 male..  the biopsy was positive with <5% in 4 of 12 samples...  the good thing about surgery is they get to do a 'final' total biopsy of the gland.  In my case, I was lucky that there was no increase in the gleason score (6 before..and 6 after)  and no spread to the lymph nodes or seminal vesicles.   The biopsy is not accurate necessarily..even if it clean, it could have missed some cancer.   I would just followup with your urologist to confirm .. if any  further treatment is necessary.. have you had a followup PSA test?