Liver Biopsy

My father has a 2.7cm mass seen on a sonagram (can't do an MRI, he has stents).  CEA is 16.  (He had colon cancer about 5 years ago that effected one lymph node, but didn't break through the colon wall.)  Rather than start him on chemo immediately (or schedule an operation), they decided to give him a biopsy.  I think they want to make sure it's malignant before they attack it.  I was wondering if anyone has had a biopsy and the mass wasn't cancerous.  My hopes are slim, but I still have them.

Oh, and why are they waiting so damn long, if anyone might know?  They did a ct scan about a month ago, then scheduled a sonogram and that didn't happen til last tuesday, and now the biopsy isn't until July 1st.  I'm sort of concerned that all the time in between tests is time for the mass to grow and become more and more dangerous.  If anyone has any experience with this and would like to reply, please do so.  My mother and father go to the doctor together then tell me what happened.  And I have questions that I don't want to ask them because I don't want to cause my father any undue stress.  Or maybe I just need the commiseration.  Thanks

 Nick

Sorry to hear about your father's suspected diagnosis.  We've been going through similar issues w/ my dad. Anyhow, in answer to your question, yes, biopsies can sometimes come back negative.  W/ my dad, they were positive he had kidney cancer, only to have the biopsy for that suggest that the growth they were focused on was only a cyst.  He has confirmed carcinoma from a different biopsy site so right now his dx is cancer of unknown primary -- we are still praying that they can specify the kind of cancer he has so that it can be treated in a targeted way.  In terms of long interludes between appointments, what we have learned is that it is important to try to schedule placeholder appointments and take an overlapping approach (e.g., set up an appointment w/ the oncologist now even before the biopsy takes place) if you have any concern about keeping things moving along. Also, see if the medical center where your dad is receiving care has a cancer care coordinater, who can help facilitate/expedite appointments, etc. Best of luck to both you and your father.

There are some biopsies which come back negative. Be careful; this does not always mean a clean bill for the liver. It can be very challenging to do a liver biopsy. It is very easy to "miss" the tumor and get only a sample of normal tissue. The biopsy should be done by an interventional radiologist, not a "blind" biopsy by a GI doctor. The radiologist is guided by ultrasound to locate the suspicious mass and make sure he/she is aiming in the right direction before taking the sample.

Regarding having to wait for tests: I too had a supicious ultrasound, had to wait a month for an MRI, and then had to wait another month for the biopsy. All I can say is you have to be very proactive to make sure you are getting the first available appointments. If you are not satisfied with the results of the biopsy, you can request to have the actual slide sent to another pathologist for another opinion. Good luck to you!

Violarob in Texas

Thanks everyone for the responses and the information.  I really appreciate it.  An update: Had the ultrasound biopsy done last Tuesday.  Two days later we get a call from the oncologist.  Now, this is not our regular doctor.  Our regular doctor is on vacation.  This is the substitute oncologist.  And she says that we need to redo the biopsy.  Why?  The results were negative, and given my father's past history of colon cancer and his elevated CEA number (~16), she feels it is unlikely that it's not liver cancer.  She seems to feel that the doctor that did the biopsy missed the tumor tissue.  But he WAS using an ultrasound, so I don't know what that means.  And of course we couldn't get hold of the doc that did the procedure because of the holiday.  I'm hoping these people don't drag their damn feet and make us wait another month for a second biopsy.

Now, it was also suggested that his liver might just be fatty and the spot on the ct scan and the pet scan and the ultrasound could have been just that.  And as for the elevated CEA number, he was taking a new Diabetes medication that is apparently known to cause an elevation in these numbers.  Add to that the fact that his liver is functioning, in the doctor's words, perfectly.  Not in the high normal range, or the low normal range, all of his liver nunbers are supposed to be perfect.  But it just sounds too coincidental to me, although it IS what we're all hoping for.

Again, thanks for the information and the well wishes, it is most appreciated, and I hope the best for all of you.