How is a biopsy used to detect prostate cancer?

A biopsy is a technique used to determine if prostate cancer is present in the gland. Small samples of tissue are taken through a fine needle. These samples are then examined under a microscope to determine if the they are malignant (cancerous).

A prostate biopsy is performed to see if cancer is present in the prostate gland. There's a 1 percent risk of infection after a prostate biopsy. As bacteria become more drug resistant, the risk of infection increases, although we have not had this problem at this institution. We use local anesthesia during the procedure, but postoperatively there’s some pain and there’s a risk of bleeding. There was a study published in Canada that reported a 1 percent lethality associated with prostate biopsy. We’re collecting data to contradict that study because we have never seen anything like that.

If urinary difficulties are present, or the results of a digital rectal exam or a prostate-specific antigen (PSA) test are suspicious, your doctor will probably recommend an ultrasound and a biopsy to rule out prostate cancer. The kind of biopsy used with the prostate is a core needle biopsy. It is a surgical procedure in which a sample of tissue is removed for examination under a microscope. Transrectal ultrasound is used to guide the insertion of a narrow needle through the wall of the rectum into the prostate gland. The needle removes a cylinder of tissue, usually about 1/2 inch long and 1/16 inch across, which is sent to a laboratory for microscopic analysis by a pathologist to see if cancer is present.

The biopsy procedure is usually done in the doctor's office and takes about 30 minutes. Though it may sound painful, it typically causes little discomfort because a special instrument called a biopsy gun inserts and removes the needle in a fraction of a second. Several biopsy samples are often taken from different areas of the prostate. Usually six samples are taken (upper, mid and lower areas of the left and right sides) to get a representative sample of the gland to tell how much of the gland is affected by the cancer. But, in some cases, such as especially large glands, as many as 18 samples may be taken.

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