Decision time - Doc has found an area of concern via CT- node 50% enlarged. CT radiologist ruled negative, PETScan returned negative. However, doc and I are still concerned - options at this point is take another CT in about a month to assess change in the node or neck dissection on November 3rd. What is the reliability of fine needle biopsy? My doc is not optimistic on this procedure due to false negatives. I am strongly considering a second opinion, is Anderson's hard to get into?

John,
just thought I'd let you know that my husband had a fine needle biopsy on his lymph node that came back negative. Later node was excised and found to contain cancer. From what I have read, this is pretty common.

Good luck in your decision - I know trying to weigh all the options and decide what to do is really hard.

Anita

Your doctor can take your results and transmit the data to MD Anderson and consult with someone there on your behalf. It can be done in a day's time. Look on their website and get the toll-free number. Call and tell them what you want to do and they will direct you. They connected with directly with the Head and Neck Cancer department. Good luck and I hope everything comes out negative. The needle biopsy is fairly reliable, provided they really get the area of concern. It is sometimes difficult to pinpoint and guide the needle.

Ed

John618, I had multiple fine needle biopsies between various scans (Pet and CT) and everything came back suspicious but not conclusive. I finally had a sonogram-directed large needle biopsy and bingo, I won the prize, SCC of the lymph node with unknown primary. In a week and a half, I had a tonsilectomy and the primary site was found in my right tonsil. So if the fine needle biopsy doesn't work for you, you might try a sonogram-directed large needle biopsy to get enough tissue to properly test. Will pray for your results.

I think that to some extent fine needle biopsy should be quite a reliable tool to determine cancer. In my case, I had it for my left tonsil and during the ultra sound to the neck, the doctor took some tissue from the lymph nodes for biopsy. That was all the doctors did and after a few days the diagnosis was confirmed. A series of other scans was done to determine the status and stage, etc.The biopsy doesn't hurt at all and I think it is worth giving a try. As my oncologist told me, their usual practice is during the ultra sound, if anything suspicious shows up, the doctor will do the biopsy after getting the patient's written consent. So in my subsequent scan tests after treatment, I felt much relieved already if the doctor released me after the scan without performing the fine needle biopsy because I was almost 99% sure that the scan was clear.

Karen.

John, the fine needle biopsy is perfectly accurate....but only if it is perfectly targeted. Cancer cells are small so if the cancer is also small, the chance of missing is pretty high. If it were me, I would be discussing the neck dissection at length with your doctor. With the node/s completely out, the pathologist will be able to make a much better determination. Of course if there are any cancer cells, you will probably hear about radiation (for good reason)

Take care

John-
When anyone says wait a month and see what happens to a node that is already enlarged it makes me really nervous. This cancer is so aggressive - it can spread quite quickly to other nodes. I had one enlarged and it wasn't until they did the neck dissection removing 54 that the pathologist found two more that did not show up on scans.

A neck dissection is very survivable. The after effects are pretty minor compared to living. It may be worth the peace of mind to know it hasn't spread! - Kris

John I had the same thing happen, PET/CT showed up positive, doc had me take antibiotics and did the test again a month later. Followed it with a sonogram guided needle biopsy, came back positive.

But, remember, my case is different from yours, my scans were positive to begin with, they just didn't want to act on false positives, which is apparently more likely than false negatives even though both are possible.

A good thorough sonogram guided needle biopsy done by an experienced doc should be fairly reliable. Still probably not 100%, only dissection is that, but better than a needless surgery. Sometimes the sonogram itself will tell what's going on. Had that happen also, a bump under my chin that showed up negative in pet/ct, was going to have biopsied, and the sonogram showed it apparently wasn't anything of concern. That was 3 PET/CT's ago, and apparently it's still nothing of concern.

Would try for the second opinion though for piece of mind.

Can they do a surgical biospy of just the lump without doing the neck dissection? Then if that comes back positive, go for the neck dissection. They did this with me because the first time I had cancer because I didn't want to wait 14 days for the results and my surgeon doesn't trust negative results of a needle biospy. Hope yours is nothing.

Take care,
Eileen