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Selecting Active Survelliance based on GG1 and small GG2 in biopsy?
Prostate Cancer | Last Active: Dec 8, 2023 | Replies (25)Comment receiving replies
I had a TRUS biopsy and the results came back 3+4. Wish I could have had a MRI fusion biopsy like you. I then sent the samples for Prolaris testing. It came back I was on the borderline for active surveillance/treat. I decided to have my prostate removed at Mayo. Post surgery pathology came back upgraded at 4+3. Seems the biopsy missed significant cancer. I'm glad I had it removed. Catheter kinda sucked but it was only for seven days. I had 0 issues with incontinence, 0 leaks. I was very pleased. Still have some ed but i'm only 3 months out. I refrained from lifting anything over 10 lbs for six weeks but have no limitations now. I'm 59 by the way. Tuesday I go for my first PSA post surgery. It's a tough decision about how to proceed and I can tell you I prayed quite a bit and asked for guidance. Never thought Mayo was an option due to being out of state but low and behold, I was moved to make the call, and they accepted my insurance. Best wishes on whatever path you choose. I hope all goes well!
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Thanks for your comments!
In my case, three lesions were found (3, 4 and 5 PIRADS) in the mpMRI.
The fusion targeted portion of my biopsy found 3 + 3 Gleason in the 4 and 5 PIRADS lesions and benign tissue in the PIRADS 3 lesion.
If it hadn’t of been for the random 12 core biopsy, performed at the same time, my two 3 + 4 cores would not have been found.
Even so, both 3+4 cores were found with only 20% fused cell 4 type (no cribriform or intraductal carcinoma). Maybe that’s why (being too small) they weren’t able to be detected in my particular mpMRI scan…I don’t know.
I’m awaiting a 2nd opinion of my biopsy report.
The point is that mpMRI can over diagnose and (apparently) miss very small, possibly more significant lesions.
In fact, mpMRI over diagnosis of PIRADS 5 lesions is quite common, even at the “best” prostate specific mpMRI reading laboratories (see my 2nd question thread for details about this issue).
It’s good to hear you are pleased with the results of your RP.
All the best to you for a PCa free future!