Do you insist on biopsy confirmation of invasive disease in the setting of in situ pathology findings but otherwise clinical/radiographic evidence of invasive cancer?

Not necessarily. I recently had a case of cervical cancer which was called CIN 3 on 2 consecutive biopsies with a palpable mass approximately 3cm in size on clinical exam. PET/CT showed intense FDG avidity in the cervix with a 5cm mass and pelvic lymph nodes. We treated as a IIIC invasive SCC.

While...