A biospy during surgery and get immediate results?

[2weimies]

How do they do that? I mean I understand they take out the nodule or whatever and look at it ,but is there an actual pathologist or some biopsy doctor standing there to test it and know immediately?? Sometimes I hear people are waiting for reports after surgery so how can they do it immediately?? any ideas?? Since being told they will biopsy it in surgery and determine if its cancer that I'd get a more invasive surgery and removal of an entire lobe of my lung I have begun to wonder how that determination is done.Thanks

[Liz13]

My guess is that if needed there is probably a patholigist on call. When I went in I was to have my upper lobe removed. CT and PET both indicated stage 1. After opening me up they could feel (see)the cancer was larger then expected with possible lymph node involvement. They did biopsy right there. When they were confirmed cancer, they closed me back up. They knew I would have to do chemo and radiation, so why weaken me with the surgery. They don't want to do surgery unless they are really sure of getting it all. The thing you want to hear is "We took it out". It devastated me to hear they couldn't, because I knew what that meant.

[Andrea]

I don't know the technique, but they run it down to pathology immediately for an initial read so the surgeon knows how to proceed and the pathologist calls the OR with the results. They did that with both of my parents.

With my mom, a lymph was positive, so she was closed up to do chemo before her surgery.

With my dad the biopsy told the surgeon it was BAC, so he chose not to remove the entire lobe.

[2weimies]

I have no idea what BAC is.Sorry I am now really confused. Wonder why they can't figure all this out before cutting you open. Did he have a VATS procedure or fully cut open and then closed?

[Andrea]

BAC is bronchiaevelor carcinoma, it is a rare form of Lung Cancer.

My dad first had a biopsy. The intial path on the biopsy done the day of the biopsy was negative. We received a call a few days later that after the final path report, it was suspicous for cancer, so he needed surgery to confirm or rule out. Biopsies are not always 100% conclusive. ALso the tumor can be in a hard area to biopsy, so they don't always biopsy it first. Hence they jump to s urgery.

My dad had VATS and the biopsy was done to determine if it was cancer, what kind, and then how much to remove. So results were instant. However they only look at a small section immediately, the formal pathology report comes out later. VATS is still major surgery, it is just an easier recovery than full cutting.

My mom had a mediastonoscopy first which would have led to a VATS if the lymph nodes were clean. That was a full surgery too, but not as invasive.

[Muriel]

Yes, they can do it. And generally do. They freeze a section and send it to Path. where a Dr. is waiting to make a tentative Dx. right away. That happened in both of my surgeries. After the lung, lobe, or section is removed, more samples are sent to Path. It takes longer then, because there isn't the rush for immediate info. My Dr. has always (twice) had the final path. results when I returned 10 day. after surgery.

One reason they do it that way is because CT and Pet scans aren't perfect. Also, they need to know the type of cancer to plan chemotherapy, if that is to follow.

If you were to do a "search" on the internet of (1)lung cancer, (2) thorasic surgery, lung surgery, (3)treatment options for lung cancer you would find a wealth of information. You probably wouldn't be quite as worried about the procedures and logic. I found all of this info. on the internet before my first surgery. It really helped me to know as much as I did. You could ask your doctor, but the questions often don't come up until you've left his office and thought about things for a while. Also, he/she really doesn't have time to answer those kinds of questions for each patient he/she sees.

Muriel

[twodogs]

In the midst of all my other activities I was also treated for Squamous Cell Skin Cancer. During this surgery they sent the samples out while I waited for the results. Good deal, as I needed additional surgery to remove all the tumor and got it all done in one day.

This was done out-patient at a clinic in SD. I know they had a path lab nearby at the regional hospital.

They did the same thing while my daughter was undergoing BC surgery in Seattle.

My guess is that they use this procedure whenever they are actually doing cancer surgery as opposed to exploratory,(?), biopsies. If that makes any sense.

John

[Tom K]

I had nodules on my liver that also showed uptake in a PET scan. Because of the location of the nodules, they had to do surgery to do a biopsy. My doctors were able to tell me the pathology results as soon as I woke up in the recovery room. You should ask your doctor when he will have initial path results. Ill bet he will have them immediately after surgery.

[DrWest]

As Muriel indicated, the "frozen section" is the preliminary read on the pathology, done in real time while a patient is in the OR. It's basically to determine if it's cancer or not. Also, sometimes they'll do a quick read on whether certain important lymph nodes are involved, such as during a mediastinoscopy. The lymph nodes assessed during a mediastinoscopy, which looks at the lymph nodes in the middle of the chest, are important in deciding whether a patient should have chemo or chemo and radiation before surgery, or maybe chemo and radiation alone without surgery. They'll also tell a surgeon if the margins of surgery have cancer involved on the edges, which may require them to do a more extensive surgery to get the entire cancer out with no cancer left on the edges.

So the pathologist does a quick reading of things on the fly. However, that's not the same level of detail you get when they pore over everything after all of the tissue has been processed, or "fixed", and cut up in fine detail. That requires at least 3-4 days and sometimes more to get the full analysis of the cancer.