HGPIN Biopsy Result

@rssplit I don't see your Gleason Scores (are my eyes just failing me?). If it Gleason 3+3 or lower, I will not worry. I was Gleson 3+4, I have cancer. And because more than half of my tissue samples are 3+4, I was considered intermediate unfavorable, else I would have been favorable. I suggest you confirm what your GS'es are.

there are no gleason scores on my report.

hgpin is pre cancerous

thats what i have read but some say it has a high chance of becoming prostate cancer
and some people choose to do rp to stop from getting cancer

The end of the last line sums it up “ arguing against the presence of invasion.”. They don’t think there’s a cancer at this time. Yeah, HGPIN could mean something in the future, but not with this biopsy.’

Maybe the comments had something more informative.

that was the entire comments. i thought the report was not as detailed as i hoped. maybe a breakdown of each of the 12 core samples ??

Some biopsies go by the part of the prostate that’s being examined others go by each core. Yours is the former.

I also had an HGPIN detected from a biopsy. I was told just to continue regular PSA testing and that an increase in the PSA would warrant further investigation.

As it turned out, I had to change urologists and at my initial appointment with the second urologist he did a PSA test and DRE. The PSA was stable with previous readings and the DRE was normal. I requested one of the 'then-new' urine tests which look for prostate cancer markers in the urine - I was given the ExoDx test though there are others now that may be better. The ExoDx indicated a 36% probability of clinically significant prostate cancer and that led to a saturation biopsy which showed a low percentage (less than 5%) of Gleason 9 cancer in 2 of the 24 cores. I had a RALP six weeks later and the post-surgery pathology report downgraded my Gleason score to Gleason 7 (4+3) with tertiary pattern 5.

There is no way of knowing whether my HGPIN progressed to the cancer found 18 months later in the second biopsy, but in discussing my case with the urologist he indicated that if an HGPIN is found in a biopsy, he recommends doing a second biopsy one year later. I also think a saturation biopsy, where something like 24 cores are taken sampling all areas of the prostate, is a good idea especially in light of my case where only 2 of the 24 cores showed cancer and a very low percentage in those. Finally, for what it is worth, the urologist who did the saturation biopsy did a transrectal biopsy - not the transperineal version. He said that he feels that he is able to better access all areas of the prostate with the transrectal version.

So in summary, I would suggest a follow up biopsy in a year and ask for a saturation biopsy to make sure the prostate is thoroughly sampled.

thanks for the reply and the information. that knowledge is very helpful for me in making decisions on what steps to take. there is definitely more information on this site that can get from a dr. in their 15 minutes. i am just beginning my ride on this roller coaster . hope everything is going well for you
thanks

rssplit,
yours is an aggressive cancer, caught very early. Congrats to whoever is responsible for the catch.
Whatever the urologists opinion, see an oncologist before determining a course. Keep copies of all reports and images.
Best wishes