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How often are biopsies wrong?

Lung Cancer discussions, another of the most common forms of cancer

How often are biopsies wrong?

Postby curtiss » Fri Apr 01, 2011 6:07 pm

My father was told on Friday he had lung cancer, they found a mass 10cm by 11cm in his upper left lobe. At this point, all they did was a CT scan. Monday, they did a bronchoscopy to get a biopsy, Tuesday, they tell us it spread to lymph nodes, it's stage 3, and depending on when they do the PET scan maybe stage 4 if it's spread. They also told us depending on if it spread and if chemo works he has anywhere from 3 months to a year. Then on Wednesday, they said the biopsy results were negative, no signs of cancer, but they don't believe it and are doing a needle biopsy today because they still believe it's cancer. My question is, how often does this happen? The doctor says he is baffled by the results, he just knows it's cancer but now has to prove it.
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How often are biopsies wrong?

Postby cinneidigh » Fri Apr 01, 2011 6:09 pm

In regards to Matador: There is absolutely no diagnostic marker for cancers. The one in which I think you are attempting to refer to relates to only certain types and then is not diagnostic, rather, a confirmation in regards to other tests. You have no idea what you are referring to, and it is a bad idea to post about things you do not understand.

As far as biopsy results I will explain this simply as possible. They take cells and look at them and depending on the sample (or mutiple samples) the appearance of the cells to a pathologist will give them with nearly 100% certainty (assuming the pathologist is good) the type of cancer, if it is malignant or benign, and what treatment will be appropriate.

So in the case of your father, biopsy negative results are good. However, they will have to wait and run more tests, and possibly do a repeat biopsy to see 2nd results.
It is possible, and I would not want to give false hope, that the mass is not cancer at all. There are a number of things that can create a mass in the lungs which are not cancerous. However, without additional information it's really hard to say.

My best advice is to wait and see, although I know this is difficult. Doctors are human too and sometimes it takes time for them to figure things out. Diagnosis is never as simple as people seem to think.
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How often are biopsies wrong?

Postby beals » Fri Apr 01, 2011 6:11 pm

It depends on the kind of biopsy that was done and the location of the biopsy.
It isn’t that the biopsy is wrong it is negative because there were no malignant cells present in the biopsy specimen. This is exactly why I continually tell people here biopsy is not the only way to diagnose cancer. It sounds like your father had an FNA which are not definitive.
I do not have statistics on how often this occurs, but it is not unusual. It is surprising in your father’s case due to the size of the tumor.
There is no doubt your father has cancer. They need the histology and the stage to know how to treat it.
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How often are biopsies wrong?

Postby jeannette71 » Fri Apr 01, 2011 6:25 pm

luv my black and gold,
In this “modern age” I am continually appalled by the continuing practice of doing biopsies because there is now a blood test that will accurately detect early cancer of all types. It has an accuracy of greater than 95%. If the test is repeated, the accuracy is greater than 99%. That is to say, that false positive and false negative rates are less than 1%. The test is called AMAS. AMAS stands for "anti-malignin antibody in serum." The test is extremely sensitive; blood levels of this antibody rise early in the course of the vast majority of cancers of all types, regardless of location in the body. The test is especially useful when cancer is suspected but has not been confirmed by a biopsy. Were it not for the intransigence of established authorities, the AMAS test undoubtedly would be much more widely used. Another test that is also overlooked is yet again another safe alternative to all the expensive and/or injurious/invasive tests, and is as follows - All trophoblast cells produce a unique hormone called the chorionic gonadotrophic (CGH) which is easily detected in urine. Thus if a person is either pregnant or has cancer, a simple CGH pregnancy test should confirm either or both. It does, with an accuracy of better than 92% in all cases. If the urine sample shows positive it means either normal pregnancy or abnormal malignant cancer. Griffin notes: If the patient is a woman, she either is pregnant or has cancer. If he is a man, cancer can be the only cause. So why are all of the expensive, dangerous biopsies carried out to 'detect' cancerous growths? During biopsies or other procedures, one can dislodge some cancer cells, either into the interstitial fluid where they are carried away to lymph nodes, or possibly into the veins draining the tissue where they enter the vascular tree and travel to the lungs. It is also possible to drag some cells along the needle track or along the surgical incision. So it is possible to increase the incidence of lymphatic and haematogenous spread of the cancer, as well as local implantation along the surgical route or needle tracks. One can only assume that Medicare pays doctors a larger fee for biopsies than pregnancy tests. For obvious reasons, I am unable to comment on the details that you quote in your question, as I have no access to any results or details of any other procedures past or imminent. I wish you and your father well.



ALL ANSWERS SHOULD BE THOROUGHLY RESEARCHED, IN ANY FORUM AND ESPECIALLY IN THIS ONE. - MANY ANSWERS ARE FLAWED.

It is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms.


The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

Hope this helps
matador 89
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How often are biopsies wrong?

Postby segar » Fri Apr 01, 2011 6:29 pm

Biopsy, the study of sample tissue cells under a microscope, is still the best method of determining if there are cancer cells and what type of cancer cells. From this sample they are also now doing genetic study to determine which particular cancer cell structure. From this information they know which treatment method e.g. chemo or biochemotherapy, method is best.

AMAS tells you the body is reacting to cancer, CT and PET scans tell you where the cancer is located, but a biopsy tells the rest.

But taking a sample is intrusive so they start with the least intrusive first. In your father's case the scope, then FNA. The doctor should explain FNA that one outcome is no outcome, like the scope sample, there might not be enough cells collected to determine is cancer is present and what type. the next step would then be surgery to take some of the mass and ensuring a sample. They then stain the sample to illuminate cancer cells.

all the best to you and your father.
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