Hi everyone,
I just had an excisional biopsy and I was told that all of the mass would be removed. Now when I look at my tongue, I can still see some of the mass remaining. It appears the surgeon did NOT remove the whole thing. I am very upset about this. I heard that cutting into a mass can cause it to spread faster if it is cancerous. Did the doctor just make my problem much worse???? I dont know yet if its cancer but if it is, am I now in more trouble than before because he cut into it?

Emil, welcome to OCF!

Im sorry you are upset. OCF is made up of fellow patients and caregivers, not physicians or medical professionals. Its not possible for any one of us to second guess what happened with your biopsy/mass removal. Hopefully it turns out to be non cancerous. The best advice I can give you is to find the best medical professionals you can and put your trust in their hands. When going thru this or any major medical treatments its always a good idea to get a second opinion. Seeking out a top cancer center will also help you to avoid your situation of wondering if things were done correctly. I really hope you do not need our services and your biopsy is negative.

Best wishes with your recovery.

Thank you for the greeting. I dont think my question is any different than the many others on this board. Im asking for peoples experience and knowledge about biopsies and how cancer spreads.

Biopsies by design are a SMALL sampling of tissues, and unless the suspect tissue is some extremely small potential carcinoma in situ, doctors do not routinely try to take the whole thing. It sounds when you say the word mass, that this was not small, so it would be normal for the doctor to not attempt to take everything. If it is positive in that pathology report, then scans and other diagnostic tests will determine how much more or less extensive it is than what is superficially visible.

Doing too much cutting before full extent of the disease is known is not a good thing, and may subject the patient to the loss of structure/function that when removed, cannot be replaced.

Location also dictates some of this as proximity to neuro vascular bundles make removal of larger areas ill advised. So it seems that the doctor did what was cautious and prudent and not overtly and unnecessarily aggressive.

While you have likely read somewhere that cutting into a malignant area could spread cancerous cells, and that has some validity to it, it is a necessity to remove some tissue to determine what the situation is before attempting to remove things, have a diagnosis, and then after more tests a full staging of the tumor. The risk of spread compared to the gain of knowledge as to what it is, is a trade off that is done everyday of the week by surgeons.

Hi Emil - It was my experience that my first biopsy (which was negative) somehow (?) aggravated the cancer cells, but I can never be sure about it - maybe the biopsy it wasn't deep enough and the cancer was deeper. Even the second biopsy came back neg, when it was obvious by then that I had an aggressive tumor. But I was a very unusual case and my ENT was a very experienced SCC doctor. He did not want to perform laser surgery to 'zip off' the leukoplakia (sp?)if it was not necessary, as it has it's own risks.

If your biopsied area has any weird changes - get it checked out immediately.

Which part of your tongue was biopsied?
Can you give more details?

I DO NOT mean to alarm you in any way, I'm only thinking of my own situation and what I would do now if I could turn back time. I know WAY more due to the excellent info on this site and the wonderful people here.

Please give us more info if you can. Everyone is different as you've guessed by now.

Christine and Brian (my heroes - among many others here) have given you great insight and advice.

Hi Emil,

It might be possible also that the whole area was taken, yet there was some swelling in the area where they took the biopsy. I had a biopsy on the floor of my mouth recently and while they took the whole area, a bump remains from there they glued the skin back together (or whatever they do). Hopefully it is nothing!

Emil, my doc was 99% sure I had oral cancer, but I had a biopsy to confirm. Only a small part was removed for the biopsy, and then 3 weeks later half of my tongue was removed. My surgeon had said this was what would happen to me if it was positive for cancer.

Imagine how mad you would be if they removed a good chunk of your tongue and it wasn't necessary! That's what the biopsy is for - to make sure further involvement is needed.

Good luck!

Usually biopsies are samples. Unless its a small area then they'll take it all. Often they'll get the results and schedule the surgery as with tongue cancer they like to take nodes too. A biopsy is a short procedure - tongue surgery can be very complicated and take much longer. It is possible cutting into it can cause the cancer to spread faster , (it's a theory) no one knows for sure. Just push the drs for he results ASAP and if it is a ca dx - then make ur they don't make you wait too long. Best of luck and hope your biopsy results are clear.

Thanks Everybody for all the great advice. My biopsy came back clear thank god, so I can relax finally. SOmething is aggravating my tongue and causing it to develop a lump in one area. It is right where I had a tooth removed so IM thinking its rubbing the edges of the adjacent teeth and the friction is causing it. Doc said it may come back, but its not cancer! Thanks for all the advice!

That can change keep a close ye on the area and have it monitored regularly if it does come back. Good luck and congrats