One 10‐core prostate biopsy is superior to two sets of sextant prostate biopsies

OBJECTIVES To compare the efficiency of different transrectal ultrasonography (TRUS)‐guided prostate biopsy techniques for detecting prostate cancer. MATERIALS AND METHODS In all, 81 prostates from radical prostatectomy were used and two consecutive sets of sextant biopsies and one 10‐core biopsy taken in each specimen. The 10‐core biopsy consisted of a sextant biopsy and four cores from the far lateral areas of the prostate. To simulate a transrectal biopsy procedure, all biopsies were taken under TRUS guidance. RESULTS In the first set of sextant biopsies 44 prostate cancers (54%) were detected and in the second set 51 (63%). Combining both sets of sextant biopsies 57 (70%) of the carcinomas were detected. One set of 10‐core biopsies detected 66 (82%) of all prostate cancers. Overall, with the 10‐core biopsies 16% more prostate tumours were diagnosed than with two consecutive sets of sextant biopsies. To find the same number of prostate cancers as with the 10‐core technique, 14% of patients undergoing sextant biopsy would require a second set and 11% at least a third set of biopsies. CONCLUSIONS The 10‐core prostate biopsy technique is superior to the commonly used sextant technique and could spare patients unnecessary repeated biopsy. Even after including a second set of sextant biopsies, the total detection rate with these 12 biopsies was inferior to the 10‐core technique.