Last week I attended a seminar with UCSF where they discussed redoing the way the Gleason score is handled. They made the point that if you have intraductal, you almost definitely have cribriform. Was that mentioned to you? There’s also a chance you have large cribriform which is over .25 mm. If they did not mention cribriform you should ask him to review your slides again and look for it. You might get a second opinion on the slides even That is something I did..

They made a point that a Gleason seven is not the same if you have cribriform or intraductal. It is much more aggressive than a seven without it.

I’m Including a slide that discusses it