Biopsy Results - How accurate?

MitchellM

I started a thread a couple weeks ago about an ulcer on the inside mucosa of my mouth, labial mucosa. This ulcer was painless for the most part and worried me since I have used chewing tobacoo in the past. I also started having tingling sensation on that side of my face and even in my lips. With all that being said, I ultimately decided to have the ulcer biopsied. Results came back and I was relieved to find out that there was no cancer or anything.

What I am worried about is how these symptoms continue to persist and the ulcer has not healed from the biopsy. Even worse, there now seems to be a lump of some sort underneath the ulcer and I do remember at the time the doctor who perfromed the biopsy was quite surprised how deep the thing went. So many of these symptoms or sign scream cancer. So what I wanted to ask is, how accurate are biopsy results normally? Does it matter that he performed it with a laser versus cutting out? I read somewhere that the laser biopsy can sometimes cause complications with the results.

I'm just scared and trying to figure out what is going on. I feel like the second I tell the doctors that I had a good biospy, they gloss over all the other symptoms and my concerns. Thanks in advance for your help.

MitchellM

I failed to mention that my

I failed to mention that my ear, on the side of the face that my ulcer is, constantly hurts or is in pain. Nothing seems to help it. 

CivilMatt

not even a pinch of cancer

MitchellM,

If you want another biopsy, tell them.  Usually, a biopsy is accurate, but there are lots of H&N members who get a negative report from a needle biopsy only to find out it is positive.

Good luck and I am glad you are without cancer, but that puts the blame (maybe) on the chew.

Matt

EarThroatPain

CivilMatt said:

not even a pinch of cancer

MitchellM,

If you want another biopsy, tell them.  Usually, a biopsy is accurate, but there are lots of H&N members who get a negative report from a needle biopsy only to find out it is positive.

Good luck and I am glad you are without cancer, but that puts the blame (maybe) on the chew.

Matt

Good luck

Good luck

MitchellM

CivilMatt said:

not even a pinch of cancer

MitchellM,

If you want another biopsy, tell them.  Usually, a biopsy is accurate, but there are lots of H&N members who get a negative report from a needle biopsy only to find out it is positive.

Good luck and I am glad you are without cancer, but that puts the blame (maybe) on the chew.

Matt

Confused?

not sure what happened, but I tried responding yesterday. Anyways, I wen to the doc that performed my biopsy this morning and he said things looked like they were healing nicely. Again, I'm still concerned as I've got some pretty tell-tale signs but I really don't know what to do as the biopsy came back clean. He told me to send a picture of the ulcer 3 weeks from now. That seems like a long long time, itll be about a 6 weeks from the first time I noticed the ulcer. 

Main concern is the biopsy missed something. it was an incisional biopsy, performed with laser. I read that lasers can damage the sample, but I'd imagine the dictation from the pathologist would've noted this. Just scared and have been sick to my stomach since this whole ordeal started. 

Any advice greatly appreciated. 

Linda C.

It took three biopsies before

It took three biopsies before they finally found the cancer cells.  They were digging in the wrong spot.  Once they realized that they were taking samples from necrotic cells in the tumor they moved to the outer edges and there it was.  That took months. Lots of time for it to grow and spread.  I had an ear ache on the side of the tumor as well.  A Core needle biopsy is the way to go.  Hope things work out for you and they give you some answers as to what it is.

GavinP

Out of interest...

Hi Mitch,

I think you can relax in terms of cancer at the moment - If you had cancer the incisional biopsy would've showed it,

Out of interest what was the actual pathology of the biopsy. Sure, the cells weren't cancerous but what exactly were the cells that made up this "ulcer" ?  We're they completelty normal? Was there any evidence of hyperplasia? Or Dysplasia (pre-cancer)

Was there any infection that could be helped with a round of antibiotics, etc?

Hope it's getting better for you anyway,

MitchellM

GavinP said:

Out of interest...

Hi Mitch,

I think you can relax in terms of cancer at the moment - If you had cancer the incisional biopsy would've showed it,

Out of interest what was the actual pathology of the biopsy. Sure, the cells weren't cancerous but what exactly were the cells that made up this "ulcer" ?  We're they completelty normal? Was there any evidence of hyperplasia? Or Dysplasia (pre-cancer)

Was there any infection that could be helped with a round of antibiotics, etc?

Hope it's getting better for you anyway,

Hi Gavin -

Hi Gavin -

I apologize for the delayed response, I have been very busy with work. I never really received a definitive answer on the ulcer. The biospy report included the following:

"Histologic examination reveals a two trimmed and fragmented soft tissue specimen consisting of ulcerated mucosa. A portion of hte specimen is covered by stratified squamous epithelium which shows slight parakeratosis. Over a portion of the specimen the epithelium has been ulcerated and replaced by a fibrinous exudate which suspends inflammatory cells. The ulcer base consists of inflamed granulation tissue. The epithelium at the ulcer margin shows no viral or obvious dysplastic change. Chronically inflamed minor salivary glands are also present. There is no evidence of a neoplasm and the lesion appears relatively non-specific histologically."

So I just keep hoping this is good. It has been about 4 weeks since the biopsy itself and the sore is finally starting to heal. The acutal ucler has decreased in size, there is still red ring around it. That side of my face is still a bit swollen.

MitchellM

Linda C. said:

It took three biopsies before

It took three biopsies before they finally found the cancer cells.  They were digging in the wrong spot.  Once they realized that they were taking samples from necrotic cells in the tumor they moved to the outer edges and there it was.  That took months. Lots of time for it to grow and spread.  I had an ear ache on the side of the tumor as well.  A Core needle biopsy is the way to go.  Hope things work out for you and they give you some answers as to what it is.

Linda -

Linda -

Thank you for your response. The digging in the wrong spot is what had me worried, although it is pretty obvious where my ucler was - so I hope that the doctor did it correctly. It does provide me some comfort that the report mentioned, "The epithelium at the ulcer margin shows no viral or obvious dysplastic change." This would make me believe that the doc not only removed the ulcer but some of the outer edge as well. Again, just my assumption. When your doctor performed a core needle biopsy, was this done on a lymph node?

The thing that still worries me is the fact that my left side of the face, which is where the ulcer was (labial mucosa) is still swollen from my chin to my ear. I had a follow up with my doctor and he said that this, along with the tingling, could be a result of the biopsy itself as the body is trying to heal but I also know that swelling on one side of the face could be a sign of the mucosal cancer.

Linda C.

MitchellM said:

Linda -

Linda -

Thank you for your response. The digging in the wrong spot is what had me worried, although it is pretty obvious where my ucler was - so I hope that the doctor did it correctly. It does provide me some comfort that the report mentioned, "The epithelium at the ulcer margin shows no viral or obvious dysplastic change." This would make me believe that the doc not only removed the ulcer but some of the outer edge as well. Again, just my assumption. When your doctor performed a core needle biopsy, was this done on a lymph node?

The thing that still worries me is the fact that my left side of the face, which is where the ulcer was (labial mucosa) is still swollen from my chin to my ear. I had a follow up with my doctor and he said that this, along with the tingling, could be a result of the biopsy itself as the body is trying to heal but I also know that swelling on one side of the face could be a sign of the mucosal cancer.

Yes, the Core Needle Biopsy

Yes, the Core Needle Biopsy was done on my left lymph node.  The two needle biopsies done before were taking samples from the center which was necrotic (dead) tissue so came back negative.  I went to a different hospital and they did the Core Needle Biopsy on the edge of the tumor and found the cancer.  Good luck to you.

MitchellM

Linda C. said:

Yes, the Core Needle Biopsy

Yes, the Core Needle Biopsy was done on my left lymph node.  The two needle biopsies done before were taking samples from the center which was necrotic (dead) tissue so came back negative.  I went to a different hospital and they did the Core Needle Biopsy on the edge of the tumor and found the cancer.  Good luck to you.

Thanks Linda

Here's a dumb question. If my biopsy was done on the ulcer itself, would a lymph node be able to tell if it was cancer? Would you recommend having the tumor biospied again?