Why Your Doctor Might Order a Repeat Prostate Biopsy

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If results from a man’s digital rectal exam (DRE), prostate-specific antigen (PSA) test, or both suggest cancer, the doctor will refer him for a prostate biopsy. Each year, about 1 million prostate biopsies are performed in the United States, and of those, about one in three are cancerous.

If the prostate biopsy shows no cancer but the physician still suspects that cancer is present because of an abnormality on the DRE or PSA test, a repeat biopsy may be performed.

Approximately 5 percent of prostate biopsies reveal abnormal or atypical cells that suggest the possibility of cancer but are not sufficient to make a diagnosis. In such cases, a repeat biopsy is usually recommended because there is a 50 percent chance of finding cancer on that second biopsy.

About 5 to 10 percent of men who have had a biopsy will be told they have high-grade prostatic intraepithelial neoplasia (PIN). Formerly called dysplasia or atypical hyperplasia, PIN is believed to be a premalignant lesion. But recent studies suggest that the likelihood of finding cancer on a repeat biopsy is no greater in men with PIN than in men with normal biopsy findings. Therefore, a finding of PIN alone is not a reason to perform a repeat biopsy.