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Repeat prostate biopsy — when, where, and how
Urologic Oncology: Seminars and Original Investigations, 07/02/09

Presti JC - In a review of the indications and techniques in pts undergoing a repeat biopsy, it appears that in pts for whom repeat biopsies fail to identify cancer, yet clinical suspicion remains high, consideration for a saturation biopsy approach seems warranted.

Methods

Pts who have a persistently elevated or a rising PSA level following a prior negative prostate biopsy can be a stressful situation for both urologist and pt.

Results

In pts with a prior negative biopsy, assessing the adequacy of the initial biopsy is important.
F/T PSA is currently the most useful marker in predicting cancer on repeat biopsy, although newer markers, such as PCA3, are promising.
Repeat biopsies should include a minimum of 14 cores, the 12 cores recommended for an initial biopsy and 2 additional cores obtained from the right and left anterior apex.