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Transperineal biopsy

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User
Posted 04 Feb 2021 at 20:30

I have recently had a biopsy where they took 18 samples, 9 from each side. Does the number of samples signify the level of concern the specialists have that the DRE did indeed show, or is it a standardised procedure they give to most men? 

User
Posted 05 Feb 2021 at 10:52

Hi Catwhisperer

I had a similar biopsy (18 cores ) last June and, as others have said, nothing particularly significant in that. In the early days while waiting to get a full diagnosis I also had similar feelings of trying to ‘read into’ whether time lapse between appointments were meaningful. The basic advice is it’s not! They will call you in asap when results are available to discuss them and, perhaps, arrange for any further tests, if any, that may be needed. 

Easy to say of course but try not to worry about what might or might not be. 

User
Posted 05 Feb 2021 at 11:49

Hi I had 20 samples taken and knocked out for it and had 5 out of the 20 positive for cancer but not sure how they worked out a Gleason 3+4=7 with so few positive cores.

Good luck with your results John.

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User
Posted 04 Feb 2021 at 22:36
My OH had a trus biopsy not a trans but they took 12 cores.

Regarding the DRE, what did they say about it...normal and soft or hard and lumpy/ridged?

User
Posted 04 Feb 2021 at 23:41
That's not many cores for a Transperineal biopsy. It may just be they needed to cover the suspicious areas that presumsbly needed investigation following MRI and or DRE. I wouldn't read too much into this but make sure you get a copy of the full diagnosis in due course.
Barry
User
Posted 05 Feb 2021 at 02:07

They took 42 samples during my transperineal biopsy. I had a perineum like a pin-cushion with the mother of all bruises afterwards!

Cheers, John.

Edited by member 05 Feb 2021 at 08:38  | Reason: Not specified

User
Posted 05 Feb 2021 at 05:18

Joseph,

There are two different types of transperineal biopsy, and you didn't say which one you had.

LATP (Local Anesthetic Transperineal) is now the most common type of biopsy, performed as an outpatient.
They usually take 12 cores, that being the limit of what they think patients can stand while conscious, but if they thought you were holding up well, they always prefer to take more, particularly if you have a large prostate.

Transperineal Template Biopspy, which is done as a day case in an operating theatre, under general anesthetic or epidural. For this type, because you are much better anesthetised, they normally take many more samples - figures of 30-50 not uncommon.
Before we had mpMRI scans which allowed guiding biopsies to areas of concern, there was a variation on this called a Mapping biopsy, where they would closely sample the whole prostate, and that could be 100 or more samples.

I would not read anything sinister into the number of samples taken - it's more about what the patient will tolerate, versus more samples making the procedure more reliable.

User
Posted 05 Feb 2021 at 07:38

Consultant commented that he felt an abnormality

User
Posted 05 Feb 2021 at 08:06

Thanks you to all responses, it was in fact an LATP biopsy so maybe 18 cores enables them to check out the prostate thoroughly while they were in there. Had the biopsy on the 28th January, they have just rang asking me to go in on Monday 8th Feb after having indicated it would be 3 weeks is there anything significant to be read into that? 

Edited by member 05 Feb 2021 at 09:15  | Reason: Further development

User
Posted 05 Feb 2021 at 10:52

Hi Catwhisperer

I had a similar biopsy (18 cores ) last June and, as others have said, nothing particularly significant in that. In the early days while waiting to get a full diagnosis I also had similar feelings of trying to ‘read into’ whether time lapse between appointments were meaningful. The basic advice is it’s not! They will call you in asap when results are available to discuss them and, perhaps, arrange for any further tests, if any, that may be needed. 

Easy to say of course but try not to worry about what might or might not be. 

User
Posted 05 Feb 2021 at 11:49

Hi I had 20 samples taken and knocked out for it and had 5 out of the 20 positive for cancer but not sure how they worked out a Gleason 3+4=7 with so few positive cores.

Good luck with your results John.

User
Posted 05 Feb 2021 at 12:54

Originally Posted by: Online Community Member

Hi I had 20 samples taken and knocked out for it and had 5 out of the 20 positive for cancer but not sure how they worked out a Gleason 3+4=7 with so few positive cores.

Good luck with your results John.

They can only base your Gleason on what they see when examining the cores they have taken.  When removed prostates are more fully examined and they do sometimes find a heavier balance between cell mutation and occasionally in an area where the needle missed a more radical part of a tumour.  Therefore, where there is a change in assessment, it is usually an upward one.

As regards timing of diagnosis, this can depend on how soon a particular case can be considered by the MDT and it could be that due to fewer cases they were able to look at the OP's one earlier than usual. 

Barry
User
Posted 05 Feb 2021 at 14:10

Hi Barry,

I am hoping they got all of cancer with the Brachytherapy but only time will tell.I was signed off by my specialist in January with my PSA at 0.08 so fingers crossed that old age will get me first.

Regards John.

 
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