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Gleason Differs On Biopsy & Pathology Report

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Last Modified: February 21, 2011

Dear OncoLink "Ask The Experts,"

My husband had prostate removed and the final gleason score was higher than the biopsy had showed. Is that common? It makes you think the biopsy isn’t really reliable.

Alan J. Wein, MD, Professor and Chair of the Division of Urology at the University of Pennsylvania School of Medicine, responds:

The biopsy represents only a small sample of the prostate and therefore the prostate tumor. Therefore, it is entirely possible that the Gleason score from a portion of the tumor is higher than that obtained on biopsy. It is also possible that different Gleason scores are attached to tumor in different parts of the prostate. The condition as a whole is always treated as the highest Gleason score that exists.

This question and answer was part of the OncoLink Brown Bag Chat Series. See the full transcript of Prostate cancer treatment: where are we now?