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← Return to Surgery or Radiation if large cribriform found in biopsy?
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Surgery or Radiation if large cribriform found in biopsy?
Prostate Cancer | Last Active: 1 hour ago | Replies (29)Comment receiving replies
The whole cribriform issue is quite confusing. My 20 core biopsy showed 2 small (~.75 cm total) 3+3 spots. The concern was a note "Sections of parts C and F both show atypical intraductal cribriform proliferations (AIP), confirmed by retention of basal cell marker expression (p63 and CK903), by PIN4 cocktail immunohistochemistry performed outside and reviewed here. The
findings raise concern for intraductal carcinoma of the prostate, though are below the threshold for definitive diagnosis. "
Both my Dr's are recommending Active Surveillance regardless. PSMA showed no spread, with an SUV of 10.6. Decipher - .24 (low risk)
All this talk of large and small cribriform still makes me quite uneasy!
Thanks for anyone offering any clarification on the subject.
Replies to "The whole cribriform issue is quite confusing. My 20 core biopsy showed 2 small (~.75 cm..."
@dacaesar
The biggest problem is that there are no known treatments for somebody with both intraductal and large cribriform. It is very likely to cause a reoccurrence. You do have a decipher score of .24 so that is a real positive thing. I would be real concerned, however, as @surftohealth88 Has pointed out, Her husband waited too long and has real concerns about the future and need for treatment in the future.
You probably want to get a second opinion from a center of excellence on what you really should do.
It might make a lot of sense to get another biopsy Review. Dr. Epstein has reviewed hundreds of thousands of biopsies and is an expert in the field. You can talk to him on the phone before and after having your biopsy review done. He will fully explain to you what is going on? The only drawback is that he charges $500 and if that is out of your budget, then you have to rely on other sources for a second opinion. You want to make sure that the person doing the biopsy review is an expert in prostate cancer not some other medical problem.
Dr. Epstein biopsy
https://advanceduropathology.com
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@dacaesar
We learned about cribriform and IDC the hard way, so I will try to be restrained here with my usually panic-inducing posts.
My concern is IDC (intra ductal proliferation) If you just had cribriform and the "small kind", with that low Decipher SA would be reasonable choice. It is still a good choice IF you repeat biopsy every single year - do NOT trust cribriform and IDC to stay "low Decipher" forever. Actually they can progress to very aggressive cancer in no time. Since your results are inconclusive - how about you send your samples to be examined by another lab and get a second opinion ?
I will just say that if we knew what we know today about PC in general, gland would be taken out much sooner and my husband would have had biopsy done every year. We however had very incompetent urologist and my husband had one biopsy that showed 3+3 and than another in 5 years which than showed 4+3 unfavorable which again proved to actually be 4+5 after prostatectomy : ((((.
Wishing you all the best and please, please stay on top of your PC care. MRI every year and biopsy every 1.5 to 2 years 🙏.