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Interpretation of prostate biopsy

Ximing J Yang, MD, PhD
Section Editors
Nicholas Vogelzang, MD
W Robert Lee, MD, MS, MEd
Jerome P Richie, MD, FACS
Deputy Editor
Michael E Ross, MD


Prostate cancer is the second most common cancer in men worldwide, with an estimated 1,100,000 cases and 307,000 deaths in 2012 [1].

The increasing frequency of prostate cancer over the last decade is due in part to widespread screening with serum prostate-specific antigen (PSA) (figure 1). However, the incidence of the disease was increasing even before the introduction of this test (table 1) [2-4]. The reasons for this increase are not known; both genetic and environmental factors have been implicated. (See "Risk factors for prostate cancer".)

A histologic diagnosis of prostate cancer is generally required prior to instituting therapy for any stage of disease. Needle core biopsy of the prostate under ultrasound guidance is the most common method of obtaining diagnostic tissue. More than one million prostate needle biopsies are performed in the United States each year, and cancer will be diagnosed in approximately 20 to 30 percent of men undergoing prostate needle biopsies in clinical settings.

Other potential sources of diagnostic tissue include material from transurethral resections of the prostate (TURP), prostatectomy or cystoprostatectomy specimens, or biopsies from metastatic sites (most often lymph nodes and/or bone).

This topic review will discuss biopsy interpretation in prostate cancer. Specific issues related to clinical presentation, diagnosis, staging, and treatment of prostate cancer are discussed separately.


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