Don't know who to believe

lily2

Hello everyone, I have a question regarding 2nd or 3 rd opinions on pathology.my inital biopsy pathology was read by 2 pathologist at the same center confirming cancer.The reports never mentioed LVI.i had my pathology slides then sent to Fox Chase.Which they confirmed as well and the pathology was identical and LVI not mentioned.i Ive since then after all my treatment sent my biopsy and surgical pathology to John Hopkins for one more look.They found lvi in the original biopsy.not in the surgical.Who do I believe about this.oh and first 3 pathologist agreed that I was a grade 2.but John Hopkins said grade 3?Any input would be greatly appreciated.Thanks

ElaineTherese

Hi lily!

I'm sorry that your opinions on pathology seem confusing to you. I'm not sure about the LVI, but a tumor may be found to have different grades, depending on the part of the tumor being biopsied. (Most tumors aren't homogeneous.) My question would be whether or not these minor differences would have any impact on treatment decisions.

lily2

Thank you ElaineTherese for your responce...I did get the max treatment and achieved a pcr and extremely thankful for that. I just don' like the inconsistency of opinions on my biopsy slides.i called the original pathologist which i found out is a graduate from JH go figure lol and I questioned the new findings and he said it was very subjective with the lvi and grade.So basically a matter of opinions.Hard to except when it' my life and I expect definate answers on at least my pathology not subjective.lol

lkc

hi lily, something is not right... Typically a biopsy is a small tissue ( or can be a needle aspirate) of the lump. There would be no lymph or vascular tissue taken due to this very small specimen.

Lymph and vascular tissue is found during surgery, so the surgical report would show that.

Regarding grading. It ispossible to have 2 grades show up, as there is normally many blocks/ slide specimens in a surgical setting.

Hope that helps.

BTW , Congratulations on you receiving PCR , that's great news..

Okkate75

My biopsy showed LVI, so it's definitely possible for that to happen! My oncologist (at Hopkins, fwiw) said the biopsy could have gotten just the right spot to see it, but that LVI or not, treatment would be the same.

I think like everything related to cancer we want certain answers, but the truth is there aren't a lot of those. I'd echo the comment above: would different interpretations of your pathology change treatment? Likely not. It's super frustrating how few certainties we get! So happy to hear about your PCR.

lily2

IKC..that's what I thought it wouldn't show up on a biopsy.I think that maybe because the surgeon took multiple cores I think 9 total that's maybe the reason old lol. I just don't like the inconsistencies. I'm a firm believer that the pathologists hold the key to correct treatment and they need to get on the same page.Its undoubtedly the most important part.I did ultimately get the correct treatment with a good outcome but I also believe there are plenty of women that don't because of discrepancies in biopsies and feel this is why some women don't get great results it' just my opinion though lol.Thank u!!!😀

lily2

OKKATE75, I guess it does happen but mine wasn't caught by 3 pathologist.I mean 3 different pathologist didn' see it on the slides but one did at JH just make me wonder.lol and Thank u!!!😀