How Long to Wait for a Second Prostate Biopsy
Prostate biopsy is a tissue-sampling procedure designed to detect potentially cancerous changes in the prostate gland. The results of this procedure are typically reviewed by a specialist known as a pathologist, who can find any changes and determine their long-term significance. In some circumstances, the findings of an initial biopsy may not be clear, indicating the need for a follow-up procedure within the next several months.
Understanding Prostate Biopsy
A prostate biopsy is usually performed with a thin, hollow needle that is passed through the wall of the rectum to the prostate gland. Once the needle is in position, a spring-loaded mechanism inside of it plunges it into the prostate, trapping small cylinders of tissue inside the needle's interior. Depending on your doctor's preferences, samples may be taken only from the site of suspected problems, or from areas through the prostate. Typically, 10 to 12 samples are collected during a single procedure.
Conditions Leading To a Second Biopsy
According to the American Cancer Society, the results of a prostate biopsy may reveal changes in your prostate cells that are not clearly cancerous, but are also clearly not normal. If your pathologist finds these sorts of cells, he will label them "suspicious," and investigate further.
Depending on their physical characteristics, your suspicious prostate cells will typically fall into one of two main categories. If your cells show signs of a condition called prostatic intraepithelial neoplasia (PIN), they will look abnormal, but will not exhibit obvious growth patterns like those found in true cancer cells. Pathologists frequently place PIN cell findings in two separate categories. If you develop low-grade PIN, there is no clear indication that you will develop prostate cancer at a later date. However, if your PIN is high grade, there is roughly a 20 to 30 percent chance that you already have cancer somewhere inside your prostate. In these circumstances, there is a good chance your doctor will recommend a follow-up biopsy. The chances of such a recommendation increase if your first biopsy only included samples from part of your prostate.
Your samples may also show signs of a second condition called atypical small acinar proliferation (ASAP). If this is the case, some of the cells in your prostate will show fairly clear signs of cancer. However, the number of cells with these signs will typically be too small to meet the standards of a cancer diagnosis. Still, if you have ASAP, there is roughly a 40 to 50 percent chance that you already have prostate cancer.
Scheduling a Follow-Up Procedure
According to the Mayo Clinic, follow-up prostate biopsies are usually ordered within three to six months of the original procedure. Consult your doctor to learn more about the potential time frame for your second biopsy.
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