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You may have missed my post . I had an MRI which showed a T2 Score & PI - RADS 5 .
I followed this with an MRI Fusion Biopsy . Typically a fusion biopsy calls for 2 to 4 core samples . My Urologist , a former Head of Surgery & Head of Urology at a major hospital in Toronto , Canada , took 5 cores . He maintained " HE HIT THE TARGET AREA " .
My pathology results came back negative . Being proactive and not believing the pathology results - I proceeded to have a 2nd MRI this time with contrast and a 2nd MRI Fusion Biopsy . This time with 16 cores - of which 6 were from the same "Target Area ". This biopsy was performed by a Urologist from Princess Margaret Hospital in Toronto . Ranked in the top 5 Teaching & Research Cancer Centeres in the world .
This time the pathology results came back : 6 cores in the " Target Area " positive Gleason 3 + 3 = 6 The remainder were negative .
Once again not being satisfied with the conflicting pathology results I had a 2nd opinion of my 2nd Biopsy slides . Wait for it ; " It came back with all 6 cores in the target area upgraded to Gleason 3 + 4 = 7 -- All other cores remained negative ."
I am considering a 3rd opinion of my 2ns Biopsy PLUS a 2nd opinion of my 1st negative biopsy .
At this juncture . Who do you believe ?
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I suspect that the 2nd opinion is more trustworthy. My surgeon told me that implicitly trusted the pathologist that worked on the biopsies samples he took. As I understand it, grading Gleason score is an art because of cell variability. It not all clean, cut , and dried. Check out this link to see what some of the variability can look like. https://www.cjcrcn.org/data/pic/9260_0.png
My first biopsy in 2020 had a Gleason score of 6. My care teams (I had to switch due to logistics) both felt that either the biopsy missed significant cancer, was graded incorrectly, or most suffered from botched sampling and mis-grading.
Do whatever you need to do to have the most confidence possible to move forward. Be your own advocate. You can do this!