Prostate cancer biopsy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

Overview

Biopsy may be helpful in the diagnosis of prostate cancer. Findings on biopsy suggestive of prostate cancer include increased gland density, small circular glands, basal cells lacking, and cytological abnormalities. Most prostate biopsies are done using TRUS, but sometimes an MRI is used. They can collect samples from the prostate through the wall of the rectum, the perineum or the urethra. Men who have a prostate biopsy will be given prophylactic antibiotics to prevent an infection since there is a greater risk of infection with this type of biopsy.

Biopsy

• A biopsy is used to diagnose prostate cancer. A prostate biopsy may be done if an abnormality was found during a DRE or transrectal ultrasound. It may also be done if the PSA level was high for a man’s age or has increased over time or rapidly.
• Biopsies of the prostate are usually done using transrectal ultrasound (TRUS). During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. Several biopsies are usually taken from the prostate. They are collected from several areas of the whole prostate as well as from any suspicious areas.
• There are some methods for biopsy of prostate cancer include:

Transrectal biopsy

• Transrectal biopsy uses TRUS to guide the needle through the wall of the rectum and into the prostate.

Transperineal biopsy

• Transperineal biopsy uses TRUS to guide the needle through the skin of the perineum (the area between the scrotum and the rectum). This technique is sometimes used when the rectum and anus have been removed. A transperineal biopsy may also be used if the PSA level continues to rise and a transrectal biopsy didn’t show any signs of prostate cancer.
• The samples collected during a prostate biopsy are sent to the lab. If there is cancer, the pathologist will also give a Gleason score (grade) of prostate cancer. The Gleason score describes how fast the prostate tumour is growing and how likely it is the cancer will spread.

Transurethral biopsy

• Transurethral biopsy uses a cystoscope (a tube-like instrument with a light and tiny video camera) passed through the urethra to reach the prostate and samples will be collected with tools passed through the cystoscope. A transurethral biopsy is not usually used to diagnose prostate cancer.