Prostate cancer biopsy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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.

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.

During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. Several (6–12) biopsies are usually taken from the prostate. They are collected from several areas of the whole prostate as well as from any suspicious areas.

Biopsies of the prostate are usually done using transrectal ultrasound (TRUS), which helps the doctor guide the biopsy needle to the prostate gland. Doctors can collect cells or tissues from the prostate through different approaches.

Transrectal biopsy

During a transrectal biopsy, the doctor uses TRUS to insert a thin needle through the rectum and into the prostate. Samples of cells or tissue are removed from the prostate through the needle.

Transperineal biopsy

Sometimes the doctor will use TRUS to do a prostate biopsy through the skin of the perineum. The perineum is the area between the scrotum and the rectum. The doctor inserts a needle into the perineum and cells or tissue are removed from the prostate.

Transurethral biopsy

The urethra is the tube that carries urine from the bladder and out of the body through the penis. During a transurethral biopsy, the doctor inserts a cystoscope (a long, thin tube with a light and lens) into the urethra. Cells or tissue can be collected from the prostate through tools passed through the cystoscope. However, transurethral biopsy is not usually used to diagnose prostate cancer.