Wayne --

My knowledge, such as it is, is based on my husband's case, along with reading I have done on this site and elsewhere and conversations with his doctor. I am in no position to tell you whether to seek an additional biopsy (I'm an editor, not a doctor), but I can tell you that your report is one that many members of this site would be thrilled to have.

The NCI dictionary I cited above defines leukoplakia as "an abnormal patch of white tissue that forms on mucous membranes in the mouth and other areas of the body" and adds: "It may become cancerous" (emphasis mine). In my husband's case, his dentist noticed a tiny white patch on his tongue that had not been there on his previous visit and arranged for the initial biopsy.

When I first asked about leukoplakia (after the initial biopsy and before the excisional biopsy, done by an ENT, when we learned he was dealing with cancer), Brian responded to my questions this way:
[quote]Leukoplakia is a PRE-cancerous condition that does not always move completely into malignancy. Dysplasia are those cells which are no longer normal, but they are not really malignant yet -- an in-between state, so to speak. Dysplasias also do not always go completely over to the dark side, but they are a step in that direction -- and having them removed or watched very regularly is prudent.... Keep an eye on things even after the removal from now until forever. [/quote]And just because the progression can go from hyperplasia to dysplasia to carcinoma in situ to invasive cancer (as referenced in the article in the Oxford journal Carcinogenesis that you cite and which requires a subscription to read) does NOT -- as Brian notes -- mean that it always does.

All the best,
Leslie