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Needle biopsy question
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Needle biopsy question

› Forums › General Melanoma Community › Needle biopsy question

  • Post
    • November 29, 2018 at 10:26 am
    rg1981
    Participant

      Here is my short story and a couple of questions. December 2015 – first diagnosis of orbital melanoma, almost two years of NIVO, then progression and eye exenteration in October 2017. Last PET-CT was in the September this year. Operated area was clean and no distant metastases. However one lymph node in the neck showed glucose uptake of SUV MAX 5.6. (actually this node also appeared at several previous PETs but the uptake was really low and the size has always been stable) The size was normal. My melanoma specialist decided to wait for the next PET-CT scheduled for the beginning of January however suggested making an ultrasound. Last week I did an ultrasound. At a first glance everything was normal but when radiologist looked at the last PET-CT and did the ultrasound once again he spotted one small (1.8 mm) structure alteration in the neck lymph node. My surgeon recommend to do a needle biopsy next Monday but oncologist does not see any sense and is still recommending to wait for the next PET-CT in January.
      So what your recommendation would be? To wait for the next PET or do a needle biopsy now?

      Thanks in advance.

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    • Replies
        • November 30, 2018 at 4:03 am
        lkb
        Participant

          I always opt for more information if the risk factor from the procedure is low. Did you and your oncologist discuss how the biopsy result would influence a treatment plan? 

          Lisa

            • November 30, 2018 at 10:53 am
            rg1981
            Participant

              Hi, Lisa.

              Thank you for your reply. My onc does not want this biopsy now and suggests to wait until the next scheduled PET scan. He told me that for him the size of the lymph node will be the main indicator. His idea is if the next scan in January shows the higher uptake and/or bigger size his suggestion would be to remove this node completely. I agree that perhaps to do a surgery to remove the node is too early now but since there is something (though small) at the ultrasound, if it is possible to do the needle biopsy now (as far as I understood the procedure is fast and relatively easy) perhaps it cane make sense. So I need an advise shall I wait one month for the next scan or it makes sense to do the needle biopsy now. I will also discuss it with my surgeon on Monday but it would alos graet to get an "independent" advise.    

              • November 30, 2018 at 11:59 pm
              lkb
              Participant

                My needle biopsies have been both fast and (relatively) easy. It's hard to understand why your onc doesn't want you to have this particular one; perhaps, the surgeon could elaborate on his/her reasons for recommending it. Do you think that could help you decide?

                • December 1, 2018 at 5:43 pm
                rg1981
                Participant

                  Thank you. Actually this is what I want them to do. I agree with you that it is always better to have more info, especially when it is relatively easy to get this info. I have an appointment for the biopsy this Monday. So then we will see how it will go. 

                  • December 4, 2018 at 12:34 am
                  lkb
                  Participant

                    Hope the biopsy went well today. Keep us posted.

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