You will read what you want to read into the guidelines. Let me refer you (as you so courteously referred me) to your own quote:-
1.2.4 Consider omitting a prostate biopsy for people whose multiparametric MRI Likert score is 1 or 2, but only after discussing the risks and benefits with the person and reaching a shared decision (see table 1). If a person opts to have a biopsy, offer systematic prostate biopsy
Consider omitting, but only if you have explained to the patient the risk of relying solely on the MRI. It seems your consultant considered and ruled out omitting the biopsy.
I also think that your interpretation of the NICE narrative is taken out of context; over-diagnosis and over-treatment is a serious issue in our country, but over-biopsying is not the cause ... the problem is that men, once diagnosed, are often not confident with the 'low risk' approach of active surveillance. If diagnosed, no one is going to force you to have radical treatment.
If you know that you would not have treatment even if you were diagnosed, then save the NHS some money by not having the biopsy. My father-in-law regretted being diagnosed and refused any treatment that would affect his sex life - he only survived for 4 years but it was a very happy 4 years.
Edited by member 17 Oct 2019 at 16:56
| Reason: Not specified