Revisiting prostate cancer: Can we separate the wheat from the chaff?
نویسنده
چکیده
The technique of the standard transrectal ultrasound (TRUS)-guided prostate biopsy was initially demonstrated in the pre-PSA era, the late 1980s when prostate cancer was mostly a high volume, palpable disease.[2] Apart from the addition of extra cores in an extended biopsy technique, the technique remains essentially the same; systematic and nontargeted. It samples only 0.04% of an average size prostate, mainly the posterior gland. There is inadequate sampling of anterior, midline, and the apex of the prostate.[3] Transperineal biopsy is an alternative systematic technique where saturation biopsy is possible. It may require anesthesia and both these techniques can increase the detection of insignificant prostate cancer by chance. Furthermore, in TRUS biopsy, 47% of lesions >0.5 ml and 79% of lesions of 0.2–0.5 ml size can be missed.[4] *
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