How does a prostate biopsy work?
During a prostate biopsy, the doctor takes small pieces of tissue from different areas of your prostate using a thin needle. There are two types of prostate biopsy:
- Transrectal biopsy: guided by ultrasound, a needle is inserted into the prostate under local anaesthesia through the wall of the rectum. This is the most commonly used method.
- Transperineal biopsy: guided by ultrasound, a needle is inserted through the area of skin between the testicles and the rectum.
Prostate biopsies can also be performed utilizing information from MRI, which provides more detailed images of the prostate than is possible with ultrasound only. The MRI-guided biopsy and the MRI/ultrasound fusion-guided biopsy are typically more accurate than a random biopsy and can be performed with a transrectal approach or a transperineal approach.
The tissue is observed under a microscope to see if any cancer cells are present. If the answer is yes, it is important to determine how aggressive the cancer is. This is indicated by the biopsy or ISUP grade group which ranges from 1 to 5. The higher this score, the more aggressive the cancer is.
Read more about your options when you have an elevated PSA.