Confused about biopsy results

LiseA
LiseA Member Posts: 266

I had my first biopsy (gum) on November 18th.  Got the results on November 25th.  My oral surgeon said it was squamous cell carcinoma.  Saw the path report which said aggressive squamous cell carcinoma.

 

Then I go to MDA and they did a cheeck biopsy and results were dysplasia. They also did FNA of the lymph node (the swelling and hard like marble had been ignored by my original doctors July-November), and that came back as dead cancer cells.  

 

So MDA ordered my original biopsy slides from Oklahoma City, and they received only one.  Their path looked at it and said dysplasia.

 

They then asked for the second slide (dysplasia according to their path report), and followed this up by a conversation with my oral surgeon, the pathologist in OKC and also photos of the site where biopsy was taken.

 

Now I'm totally confused. They have prepared me for the worst case scenario surgery, and now saying it's a partial mandibulectomy.  Anyone had this happen?  My surgeon in OK believes his pathologist is correct, and MDA isnt doing something right with regard to anylysing the slides. 

Comments

  • ratface
    ratface Member Posts: 1,337 Member
    They are making you crazy

    First of all you are at MDA the best place in the world for Head and Neck Cancer. I think you have to give their opnion some heavy consideration. It sounds like you have received some treatment already becuase of the dead cells in the lymph node. Is that the case? I din't see a bio on you.

    In November you were diagnosed with SCC of the Gum. Were you treated for that? Did you have a recurrence and that is why  you went to MDA for a cheek biopsy that said Dysplasia?

     

    It's entirely possible that both biopsies were correct. The first could have been SCC and now you have dysplasia considering they are in different locations? Dysplasia is a funny thing that changes over time. My wife has had cervical dysplasia for thirty years in different levels of grading. It has also changed when different labs have done the analysis. This is not an exact science with different pathalogists and labs interpreting results different.  It seems they would probably treat the dysplasia incremently until it proves to be anything otherwise. You could search for the proper result forever and never find the answer. You are at a great place with lots of experience, they must be able to offer some reasonable solution on how to proceed? 

    When I was first diagnosed an initial FNA biopsy came back negative and then a subsequent surgical biopsy came back positive. It isn't always a clear cut path. All the best to you!

     

  • LiseA
    LiseA Member Posts: 266
    No treatment or surgery yet.

    No treatment or surgery yet. Absolutely nothing has been done because of Christmas and needing to have a lot of tests done first.

     

    We were at MDA for a week before Christmas meeting the team, having blood work, Pet Scan and CT Scans. Went back first week of January for another week and continued meeting other doctors, having biopsies, and another SCAN.  

     

    Surgery was supposed to be the 20th but I got the flu, then pneumonia, so I'm recuperating from that. Next surgery date is the 8th February, but I'm not sure yet if this is going to happen until my lungs are clear.

     

    In the meantime, I got their findings on the slides. Pet Scan and CT wasn't very blatant about the cancer either. They are sure it's in the gum area on Pet but said it was not as lit up as they were expecting.  

     

    The original path report led them to believe they were going to see more on the scans. I don't know if this is a good thing or not. It's quite confusing.  Good to know I'm in the best Place. Had considered Cancer Treatment Center, but wasn't sure how good their H&N was. 

  • donfoo
    donfoo Member Posts: 1,771 Member
    LiseA said:

    No treatment or surgery yet.

    No treatment or surgery yet. Absolutely nothing has been done because of Christmas and needing to have a lot of tests done first.

     

    We were at MDA for a week before Christmas meeting the team, having blood work, Pet Scan and CT Scans. Went back first week of January for another week and continued meeting other doctors, having biopsies, and another SCAN.  

     

    Surgery was supposed to be the 20th but I got the flu, then pneumonia, so I'm recuperating from that. Next surgery date is the 8th February, but I'm not sure yet if this is going to happen until my lungs are clear.

     

    In the meantime, I got their findings on the slides. Pet Scan and CT wasn't very blatant about the cancer either. They are sure it's in the gum area on Pet but said it was not as lit up as they were expecting.  

     

    The original path report led them to believe they were going to see more on the scans. I don't know if this is a good thing or not. It's quite confusing.  Good to know I'm in the best Place. Had considered Cancer Treatment Center, but wasn't sure how good their H&N was. 

    stay focused

    make sure your partner takes notes, so much is said it is really hard to remember all the stuff that is said, especially if there are different opinions. MDA is know as a top oral cancer treatment facility. The method they use will ensure many different doctors will have a chance to review and weigh in. I think the time frame is right and treatments are delayed due to health issues. Not much anyone can do about that. Get well soon and proceed with the plan. Good luck

  • Barbaraek
    Barbaraek Member Posts: 626
    MDA

    is a comprehensive cancer center...they will have a tumor board and several doctors will weigh in on your tests and results to come up with the best plan. Also they will have good pathologists there. If you are confused, make sure you speak up and ask questions - more than once if you have to. It helps to have someone take notes or ask the nurse or doctor to jot a note about anything you don't understand. Best of luck to you!

    Barbara