Very interesting pathology report about cribiform

That is ridiculous !!!!

Having either cribriform (especially large ones) or IDC always points to aggressiveness of a cancer so much so that for example "3+4 favorable" with cribriform becomes "4+3 UNfavorable" or according to some doctors 4 even becomes 5 - that is HOW much it is disadvantageous to have them and how important to report them .

Now, not all pathologists are well informed or have updated training ! All of those facts are actually recent discoveries and if that lab did not have "retraining" of their stuff, that is unconscionable >: (

If neither patient nor a doctor are informed that cribriforom or IDC are present how on earth than they can make any informed decision about future treatments ?????

Also - his statement that all 4 gleason slides have cribriform is FALSE ! What center is that ??? Please send me PM , I really wish to know where NOT to go.
Only about 6% of all biopsy slides find cribriform.

@surftohealth88 My second opinion at a CCC facility stated I had one pin with 10% Crib and metaphorically yawned. Gave me a 70:30 chance of never having to revisit this after my current treatment. Oncology Surgeon used it as a selling point to get the removal job which I now view as manipulation. If you haven't personally seen the slides, how can you emphatically say the doctors information is false? The value of this forum is prostate cancer patients personal stories and experiences. What did your slides look like?

That is ridiculous !!!!

Having either cribriform (especially large ones) or IDC always points to aggressiveness of a cancer so much so that for example "3+4 favorable" with cribriform becomes "4+3 UNfavorable" or according to some doctors 4 even becomes 5 - that is HOW much it is disadvantageous to have them and how important to report them .

Now, not all pathologists are well informed or have updated training ! All of those facts are actually recent discoveries and if that lab did not have "retraining" of their stuff, that is unconscionable >: (

If neither patient nor a doctor are informed that cribriforom or IDC are present how on earth than they can make any informed decision about future treatments ?????

Also - his statement that all 4 gleason slides have cribriform is FALSE ! What center is that ??? Please send me PM , I really wish to know where NOT to go.
Only about 6% of all biopsy slides find cribriform.

@surftohealth88 I totally agree that saying all Gleason 4 slides have cribriform is false. What I just learned from you is that a grouping of Gleason 3 cells can legitimately be upgraded to Gleason 4 if there is some cribriform pattern mixed in. Additionally, Gleason 4 cells with cribriform pattern can be upgraded to Gleason 5.

What I had previously thought was that a grouping of Gleason 4 cancer cells stayed at Gleason 4 and either had cribriform pattern present or not. I had always thought of cribriform as an independent feature in the same way that intraductal stands alone. I did confirm with google AI that cribriform affects the Gleason score while intraductal stands alone and does not affect the Gleason score.

Unfortunately it still comes down to a human reading the slides. And humans will have different opinions. Maybe someday AI will read the slides and other tests (if they don't do already at some places) and give a definitive test result......

@wwsmith
Unfortunately, intraductal seems to be much more difficult to Treat than cribriform.

Here is a really great video UCSF did discussing Cribriform And intraductal. They said that they found that most of the time when somebody had intraductal they also had cribriform.

They also mentioned that somebody that was 3+4 would have a five in their Gleason score if they had cribriform. Discussed in this video.
https://www.urotoday.com/video-lectures/a-journal-club-for-patients-with-prostate-cancer/video/mediaitem/4452-unfavorable-histology-classification-aims-to-reduce-unnecessary-treatment-journal-club-jesse-mckenney-cornelia-ding.html
Then there’s This article which discusses how difficult it is to treat intraductal
https://pubmed.ncbi.nlm.nih.gov/40186732/
It’s frustrating to try to help somebody that has both of these things since there are no known solutions.

I was a little confused by the signals I got from every doctor. I was Dx as 3+4. W/cribiform.
John’s Hopkins did 2nd opinion. One core 4+3 w/cribiform.
Treatment at Univ of Cincinnati, they reviewed slides and said 3+4. All said cribiform.
What was strange to me was that Google really said how adverse cribiform was. But the 4 doctors I got opinions from, (1 focal, 2 Ro and one MO never mentioned the cribiform.
When I pushed it, all of the doctors said “it’s a ‘bit’ more aggressive but not so much if IDC isn’t present and testing shows no PTEN loss.
I thought it was a death sentence and they all just kind of glossed over it.
This was after a Decipher which showed a 3% 10 year risk of metastasis and
- PTEN Intact
- very low hypoxia (very responsive to radiation)
- very low emt signal
Basically they all said I had a tumor with a very poor environment to proliferate. Even with cribiform.

I was a little confused by the signals I got from every doctor. I was Dx as 3+4. W/cribiform.
John’s Hopkins did 2nd opinion. One core 4+3 w/cribiform.
Treatment at Univ of Cincinnati, they reviewed slides and said 3+4. All said cribiform.
What was strange to me was that Google really said how adverse cribiform was. But the 4 doctors I got opinions from, (1 focal, 2 Ro and one MO never mentioned the cribiform.
When I pushed it, all of the doctors said “it’s a ‘bit’ more aggressive but not so much if IDC isn’t present and testing shows no PTEN loss.
I thought it was a death sentence and they all just kind of glossed over it.
This was after a Decipher which showed a 3% 10 year risk of metastasis and
- PTEN Intact
- very low hypoxia (very responsive to radiation)
- very low emt signal
Basically they all said I had a tumor with a very poor environment to proliferate. Even with cribiform.