Prostate Biopsy Evaluation & Results

December 5, 2009 by Prostate Dr. 

The pathologist is the physician who receives the tissue specimens (blood, biopsies, prostates) from your urologist or surgeon . He works in the lab, and will now analyze and diagnose the received specimens. Nobody really emphasizes the importance of the pathologist, and the lab seems like a black box most of the time: the samples go in and the diagnostic comes out. The inner workings are a mistery for most people.

In his book "A Revolutionary Approach to Prostate Cancer", Aubrey Pilgrim mentions the following:

"Although the patient's prostate biopsy should be diagnosed by a pathologist who is proficient in interpreting this type of specimen, the patient (and increasingly the urologist) rarely has the opportunity to choose his pathologist. While the urologist may know of a pathologist with special competence in evaluating prostate samples, the insurance company has in most cases already contracted with a specific commercial laboratory to handle the specimen, effectively removing the urologist's professional opinion from this decision. Nevertheless most general pathologists are well­trained and are competent to read the great majority of prostate needle­biopsy and prostatectomy specimens. If general pathologists see enough prostate specimens to gain familiarity with the subtle variations of normal tissue and the various forms of malignancy, and if they develop a healthy respect for the hard­to­diagnose cases (i.e., those which need to be seen by more experienced eyes), they can provide a valuable service."

Tissues are graded according to their ability to retain their normal appearance. The more disrupted the normal glandular architecture, the higher the grade of tumor and the poorer the prognosis. But remember: the only way one can be sure of the result of the biopsy is if a radical prostatectomy is performed for cure. Otherwise, if the cancer is missed and you have a negative biopsy, then it could cause a real problem.

A Pathology report will be the result of the pathological exam and you should try your best to grab a copy, thus becoming better informed and able to make the right choices.

    Here is what the structure of such a report:
  • Your name and associated personal identifiers (age, patient number, etc.)
  • The accession number of the case (Usually in the form of "S­year­ number", e.g., S­96­16258)
  • A gross description of the specimen (including the number and size of the tissue cores) received by the laboratory.
  • The diagnosis, which reduced to its most basic form is either benign (normal), atypical/suspicious, or malignant (cancer).
  • The name and signature of the responsible pathologist along with the name and address of the lab.

All this being said, i wish you a Happy NED (No Evidence of Disease) as a result of your Prostate Biopsy.

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