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High PSA, but MRI is negative. Biopsy or Not?

Prostate Cancer | Last Active: 7 hours ago | Replies (55)
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Profile picture for ezupcic @ezupcic

@handera would you say that a saturation biopsy is still a good way to go even when there are no focal lesions to target, a somewhat clear MRI (pirads 1 or 2), fluctuating psa, lower PSA density, enlarged prostate? or more diagnostic testing?

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handera | @handera | Nov 25 10:20am

@ezupcic

Personally, I wouldn’t pursue in the case you mention; but I’m sure there are those that might.

My personal significant negative side effect experience with a lot of biopsy cores (21 in my case) definitely clouds my opinion against a so called “saturation biopsy”…when there is nothing to target.

My opinion is also based on the strongly held medical opinion (in some circles) that “MRI invisible lesions” are undoubtedly small…. therefore why not wait until there is clear evidence of something to actually target, since PCa is generally slow growing.

I know others may strongly disagree, thinking a 2mm 4+5 lesion may be lurking just under the radar…

At the end of the day it’s all about one’s individual perspective of risk/reward.

All the best!

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