Histopathological findings in extended prostate biopsy with PSA < or = 4 ng/mL.

OBJECTIVE Cancer detection has been reported in up to 27% of patients when lowering the PSA cutoff to 2.5 ng/mL. Although this practice could increase the number of biopsies performed, it also could lead to more frequent detection of significant prostate cancers at an organ-confined stage and/or a less aggressive state. This study describes the incidence of malignancy and tumor characteristics in extended prostate biopsies with PSA 4 ng/mL, respectively (p=0.906). The median Gleason score was 7 independent of PSA > or 4 ng/mL and PSA or 4 ng/mL, and tumor characteristics are similar between the two groups. Only clinically significant tumors were diagnosed following radical prostatectomy.