Question about biopsy ...

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Michael's Wife
Regular Member

Date Joined Aug 2007
Total Posts : 150
   Posted 1/13/2008 7:26 PM (GMT -6)   
Over time I've noticed that most who post on this forum have much lower percentages on positive samples from the biopsy. My husband had three out of twelve that were positive and they were all pretty high (two of them *very high*). Am I over-thinking the implications, or is just "the luck of the draw?" This is probably one of those questions with no real right answer, but i find myself wondering ...

Husband: Age 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)

Pre-op prostate study - November 13
Brachytherapy - December 12, 2007
CT Scan January 11, 2008

So far, so good!

New Member

Date Joined Jan 2008
Total Posts : 3
   Posted 1/13/2008 7:51 PM (GMT -6)   
When I had my biopsy, the MD was going to initially do 12. He stopped at 10 because he felt positive of what the results would be. 3 out of my 10 were positive. When I had surgery 6 weeks ago, the margins were clean and the lymph nodes were negative. I'm not sure that there is a total correlation between the number and the final results (but there is some).

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 1/13/2008 8:59 PM (GMT -6)   
There really is no correlation. I had only 5% of one core be positive. it was one millimeter long of cancer. Your doctor had a lucky aim and it could be that the tumor is not that big, but just happened to be right near where he was sampling. This kind of thing can sound so scary, but those high numbers are offset by a low gleason score, it would seem to me.
47 at Diagnosis.
1/06 PSA 3.15
1/07 PSA 4.6
10/07 PSA 5.06
Biopsy 3/07 just suspicious
Biopsy 11/07  1 of 12 with 20% involvment
Gleason (3+3)6
Father died of Pca 4/07 at 86.
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC
No visible cancer. Saved both nerve bundles.

Veteran Member

Date Joined Oct 2006
Total Posts : 626
   Posted 1/13/2008 9:00 PM (GMT -6)   
The biopsy results generally only indicate that cancer is present and the aggressiveness of the cancer. It cannot indicate conclusively to what extent the prostate gland is cancerous. Certainly the more samples that indicate cancer and a higher percentage of cancer within these samples would suggest the degree of cancer within the gland. I do not believe though that your husband's 3 out of 10 with high percentages in those three would suggest that his prostate is more cancerous then the 1 out of 10 with a 40% cancer in the one that was my case. Some prostate cancer is multi focal or more then one tumor and the biopsy may hit more due to this situation then it would with a single tumor. Since you chose Brachytherapy your only measure of the success of treatment will be the PSA's over the next several years. I would not worry any more about the biopsy and would not consider it to have any implications on the success of the treatment you chose.

Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07

Michael's Wife
Regular Member

Date Joined Aug 2007
Total Posts : 150
   Posted 1/14/2008 5:29 AM (GMT -6)   
Thanks, everyone, for the great explanations. Makes sense.

Regular Member

Date Joined Dec 2007
Total Posts : 65
   Posted 1/14/2008 11:18 AM (GMT -6)   


I guess no matter how much they find it's still cancer, whether it's one core or 5 positive, they apparently still act on it.  My husbands original biopsy showed a higher gleason score and percentages.  The Final surgery path report showed a lower gleason score and only 5% containment.  We're not going to argue with that.. lower is better!  The reports were taken at different hospitals, thus different individuals.  We sure are at their mercy to report to us the correct findings. 


Husband 55 years old
No symptoms
PSA taken on routine health exam
06/18/07  PSA 9.2
07/14/07  Put on antibiotics for a month
09/18/07  PSA 8.77
09/18/07  PSA % Free  9.61
10/17/07  Biopsy =  Gleason 3 + 4  (7)
10/17/07  Biopsy 40% Right Side less than 5% Left Side
12/31/07  D Day!  Davinci Surgery Day - Jon Huntsman Cancer Institute
12/31/07  Left side nerves spared, Right side partial, right nodes taken
01/03/08  Home from the hospital! Let the healing begin!
01/11/08  Cath removed, post-op gleason 3 + 3 = 6, nodes clear
                Margins - capsular invasion but no penetration.  T2C

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