What Is Dysplasia?
Dysplasia is a precancerous condition that doctors can only diagnose by examining tissue samples under a microscope. When dysplasia is seen in the tissue sample, it is usually described as being “high-grade,” “low-grade” or “indefinite (or indeterminate) for dysplasia.”
In high-grade dysplasia, abnormal changes are seen in many of the cells and there is an abnormal growth pattern of the cells. Low-grade dysplasia means that there are some abnormal changes seen in the tissue sample but the changes do not involve most of the cells, and the growth pattern of the cells is still normal. “Indefinite (or indeterminate) for dysplasia” simply means that the pathologist is not certain whether changes seen in the tissue are caused by dysplasia. Other conditions, such as inflammation or swelling of the esophageal lining, can make cells appear dysplastic when they may not be.
It is advisable to have any diagnosis of dysplasia confirmed by two different pathologists to ensure that this condition is present in the biopsy. If dysplasia is confirmed, your doctor might recommend more frequent endoscopies, or a procedure that attempts to destroy or remove the Barrett’s tissue, or esophageal surgery. Your doctor will recommend an option based on how advanced the dysplasia is and your overall medical condition.
If I have Barrett’s Esophagus, how often should I have an endoscopy to check for dysplasia?
The risk of esophageal cancer developing in patients with Barrett’s esophagus is quite low, approximately 0.5 percent per year (or 1 out of 200 per year). Therefore, the diagnosis of Barrett’s esophagus should not be a reason for alarm. It is, however, a reason to have periodic upper endoscopy examinations with biopsy of the Barrett’s tissue.
If you have Barrett’s esophagus and your first two upper endoscopy examinations with biopsies (performed about one year apart) do not show dysplasia, then upper endoscopy with biopsy should be repeated about every three years. If your biopsy shows dysplasia, then your doctor will make further recommendations regarding the next steps.