Pathologic Characteristics of Repeat Prostate Biopsy After Initial Negative Biopsy

Jeremy Weiss*, Phillip C Ginsberg, Michael J Metro, Richard C Harkaway
Albert Einstein Medical Center, Philadelphia, PA

Objectives. To review the pathological characteristics of positive prostate biopsies after one or negative or suspicious biopsies in order to improve counseling and ameliorate patient apprehension prior to repeat biopsy
Methods. Between January 1996 and December 2004, 1735 prostate biopsies were performed at a single institution. 158 people had more than one biopsy session. We compared the biopsy sets that were initially negative or suspicious with the subsequent biopsies. Data was compiled regarding repeat biopsy result, number of positive cores, laterality and Gleason score.
Results. Of the 163 biopsy sets compared, 75% (123/163) remained negative or suspicious after an initial negative or suspicious biopsy with a median time between biopsy sessions of 22.5 months. The remaining 40 biopsies that converted to positive had a median number of 1.7 positive cores, as well as unilateral disease found in 87.5% of specimens with an average Gleason score of 6.5.
Conclusions. In counseling patients prior to repeat biopsy, most likely the pathology will not be positive. If it is positive, the patient is more likely to have low volume, unilateral, low-grade disease that is suggestive of organ confined and potentially curable cancer.

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