Saturation Biopsy Procedure

So, if I understand you, he is on active surveillance now, and his next biopsy (within a year) will be a transperineal template mapping (saturation) biopsy. It won't really tell you if the cancer has spread very much. Prostate cancer does not spread that quickly that a follow-up biopsy can detect whether it's really spread. And the first biopsy was just a small sampling of the prostate tissue. What it tells you is if any significant cancer was missed on the first 12-core TRUS biopsy. about 30% of Gleason 6 cancers are found to be a higher grade when men have a prostatectomy and they are able to inspect the whole thing. So these follow-up biopsies confirm that his type of prostate cancer is safe to monitor and not treat. Over the years, he will get a better idea if his type of prostate cancer is the kind that stays indolent (about half remain indolent).

It's a good idea to have Epstein's lab at Johns Hopkins give a second opinion on the biopsy slides.

Saturation biopsies are the gold standard. Some guys have an multiparametric MRI-targeted biopsy on the follow-up biopsy. It only detects higher grade cancer, and they don't have to take as many cores. They can do both too.

Sorry about his diagnosis...but I'm also confused. He had a positive biopsy in August and now his urologist is recommending a second biopsy. That's definitely not typical. What is the reason he/she is giving you for that?

Can you also tell us what was found during his first biopsy? How many positive cores and his Gleason score? (See my signature below for how that can look.) That will let us know more about his diagnosis.

In my case, I did have a saturation biopsy after a "regular" biopsy, but my first biopsy was negative and the uro was trying to look more deeply for cancer. There was also several years between the two. In the case of the saturation biopsy it was done on an outpatient basis since they took 30 samples.