pathology acuuracy - 1265478

malki13
Posts:92

So the oncologist told us today that even though the pathology on the upper part of the lung came back negative its highly likely that its positive..."pathology reports are not accurate all of the time".

I did n't realize this...has anyone else been told this or understand this?

Thank you,
Malki

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Reply # - August 19, 2014, 12:09 PM

catdander
Posts:

Oh yes Malki, It happens all the time. The problem is that the tissue removed during biopsy can miss gathering cancer cells so the path report comes back negative. My husband is an example of that. He has had 3 core needle biopsies using a CT to guide the pathologist and he had a VATS surgery trying to get an accurate report. None of them captured cancer cells, all came back negative (also called false negative). His only positive path report came from an open thoracotomy. His is very unusual so he's an extreme example of what you've asked about.

You can do a search on the site for false negative biopsy and see many examples of what can be done moving forward.

I'm very sorry you and your mom are going through this.

All best,
Janine

Reply # - August 19, 2014, 05:44 PM

njliu
Posts: 142

Hello Janine, just a related question. Does this mean it is very unlikely to be False Positive then?
NJ

Reply # - August 19, 2014, 08:34 PM

malki13
Posts: 92

Thank you Janine for the information and kind words...I'm astounded that a report could come back negative...not on the core biopsy....that makes sense to me...but when you do pleura, fissures and upper lobe of the same lung via VATS I would think those you could take to the bank. How do docs make decisions based on such potential false negatives ?

Malki

Reply # - August 19, 2014, 10:26 PM

Dr West
Posts: 4735

False positives really aren't an issue in cancer pathology; if a pathologist sees cancer cells on the biopsy, you're dealing with cancer. You can get false positives in reviewing imaging, such as seeing something that looks like cancer on a scan but is actually inflammation or infection, but if you see cancer cells under the microscope in a biopsied bit of tissue, that's the gold standard of defining that there's cancer.

As for interpreting whether a negative result is a false negative or true negative, it depends on many factors: how suspicious are all of the other factors for cancer (is there a growing, hypermetabolic mass, or are there stable nodules in someone who also has symptoms of an infection?). Do the biopsy results show a clear alternative explanation (such as infection or inflammation) or does it appear that the biopsy just missed the intended target?

-Dr. West

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