In what situations would you treat a rectal mass as cancer despite negative biopsies?

It is not uncommon to see a patient with rectal mass highly suspicious for malignancy by endoscopic evaluation but has a negative biopsy. Usually, this is due to superficial biopsy specimens.

In our clinic, we usually get repeated endoscopic evaluation with biopsy as our first step. However, a small...

Rebiopsy. If not possible to obtain a positive biopsy, surgery. If surgery is off the table, curative intent chemo RT.

Respectfully, "Never" is usually never the right answer, and that applies here. This is a good question and something we encounter at our GI tumor boards with some degree of regularity. Our approach is typically this:

1. Rebiopsy. Our surgeons are used to this request now and many times will independe...

Simple answer. NEVER!