I see my current oral surgeon Dec 14th for follow up. It’s at our states only medical school hospital, but they dont have oral pathology.

My 1st oral surgeon, who did the biopsy sent the tissue to an oral pathology lab, top notch place, with some top of field oral pathologists.

I asked whether my next specimen could be sent there too. Curent oral surgeon said it would have to go through the hospitals pathology department first and could be sent to the other oral lab for a second read.

I have some reservations about this. I know they will get the cancer/not cancer diagnosis correct. But would be interested to know if the old lab would now grade this severe dysplasia up from the moderate, and do such grading with the exact same criteria.

Would seem to be more concerning. It may just be leukoplakia with no dysplasia or mild, but if the oral pathologist said that I’d be a bit more comfortable vs. a general pathologist.

Apart from cost and insurance aspect (I’d happily pay a bit to get the original lab), I am wondering if the same immunohistochemical stains and process would be used and if the process done by this other lab may muddy the waters when the specimen gets sent to oral pathology lab.

If I am going to go get my tongue jabbed and sliced again I would appreciate the highest confidence level in getting best pathology assesment.

I am Probably beeing too choosy for a non-cancerous lesion follow up.

The first oral surgeon kind of planted the concept in my brain when he said years ago if he was going to do the biopsy it was going to go to this particular lab, he didn’t care if my insurance was accepted there or not (it was), but that’s the only place he had such confidence in.

I bounced these minor concerns off the first oral surgeon and asked him if he’d do this 2nd biopsy or recommend me doing it with current Dr bit use same lab for a 2nd read. He said I should just go with the new Dr (#3), he being a referal from the oral surgeon (#2) the 1st surgeon referred me to. #2 moved out of area. That is this isnt the direct referral follow up specialist, but a newer specialist. These other oral surgeons seeing more patients with neoplastic lesions and pre-neoplastic lesion follow up.

I plan on requesting he biopsy it Dec 14.

Last time he said he could have done it right then, so assuming he could do it Dec 14.

I was a little surprised as the first Dr had a whole scheduling and consent and what to expect for the days after etc.

That was for a full excision of entire lesion, at least what was visible to the eye. Biopsy report said dysplastic tissue extended to the margins of the specimen, so there was “more than meets the eye”.

Not sure if the “we could knock it out right now” comment was because it would be a more minor procedure like a punch biopsy and need less stitches or what. Perhaps he just does so many more of them he has it down pat in a very effecient no big deal manner.

I am thankful for the good expert doctors I have seen and dont want to come off ungrateful or judgy or whatever.

I would be surprised if the bump came back as not dysplastic at all being adjoining to the old scar, it being slightly raised and sporadically painful.

I’ll let everyone know what I find out.

Thank you everyone.

Hope those struggling through the actual cancer treatments and recovery find comfort and strength.