Yeah, it has always puzzled me that my MRI, biopsy and path diverged so much. The path was done in a different state than the biopsy, and a second path by Epstein himself closely matched the original path. Epstein added info that the surgical margin was right lateral, 3 mm long, focally involved with cancer of gleason 3 + 3 = 6.
An MRI done before biopsy stated, "the lesion does alter the contour of the prostate, and extracapsular disease is possible". This, btw, was what shifted me into panic mode on dealing with the situation quickly. But both paths showed "no extraprostatic extension of carcinoma". My surgeon told me there was a large varicose vein sitting next to prostate, that he just cauterized off. I think this may have been the false "extraprostatic extension" in the MRI.
My biop showed pT2a, with no left side cancer, but path did show minimal left side prostate PCa, so Epstein scored me at pT2c.
My path estimated 30% of prostate was cancer. But you would not know it from my biop 12 cores info, which follows -- remember that six of the cores going through left prostate found nothing:
primary gleason = 3
secondary gleason = 4
# cores pos = 4
# total cores = 12
total linear dimension of carcinoma = 2.5 mm
total length of all cores = 97 mm
percentage involvement of all cores = 3 %
percentage involvement of core with greatest amt of tumor = 13 %
perineural invasion = none (note: path did show PNI)
AJCC/UICC stage pT2a: unilateral, 1/2 of one side or less
Yet I had 30 % of prostate as cancer???? Wonders never cease...
Jan '08-'11 PSAs 2.2 2.5 2.7 2.6, DREs-
Jan '12: PSA 3.6, DRE+
Jan '12: MRI inconclusive
Feb '12: PCaDx pT2a, 4/12+ (3 @ 3+3, 1 @ 4+3); 3% tot cores; bone scan-
Apr '12: RALP; 3+4=7; pT2c pN0 pMx; 30%; 3mm r lat margin of 3+3=6 so pT2+; EPE-; PNI+; 8 LN-; SV-
uPSAs: undetect til .025 in 02/'17; was on TRT from 03/'14 - 03/'17
Post Edited (Bobbiesan) : 6/6/2017 5:47:42 PM (GMT-6)