scholarly journals Rate of Gleason 7 or higher prostate cancer on repeat biopsy after a diagnosis of atypical small acinar proliferation

2015 ◽  
Vol 18 (3) ◽  
pp. 255-259 ◽  
Author(s):  
C Warlick ◽  
K Feia ◽  
J Tomasini ◽  
C Iwamoto ◽  
B Lindgren ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Repeat Biopsy ◽  
Atypical Small Acinar Proliferation

MP60-17 DOES ATYPICAL SMALL ACINAR PROLIFERATION ON 1ST REPEAT BIOPSY INCREASE PROSTATE CANCER DETECTION?

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Ahmed Elshafei ◽  
Ayman S. Moussa ◽  
Heather Neifert ◽  
Ganesh Kartha ◽  
J. Stephen Jones
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Repeat Biopsy ◽  
Prostate Cancer Detection ◽  
Atypical Small Acinar Proliferation

Rate of clinically significant prostate cancer on repeat saturation biopsy after a diagnosis of atypical small acinar proliferation

2021 ◽  
pp. 039156032199359
Author(s):  
Angelo Totaro ◽  
Luca Di Gianfrancesco ◽  
Francesco Pinto ◽  
Marco Racioppi ◽  
Giuseppe Palermo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Prostate Biopsy ◽  
Initial Diagnosis ◽  
Repeat Biopsy ◽  
Atypical Small Acinar Proliferation ◽  
Saturation Biopsy ◽  
Prostate Biopsies ◽  
History Of ◽  
Clinically Significant

Background: Atypical small acinar proliferation (ASAP) occurs in approximately 5% of prostate biopsies. Approximately 30%–40% of these patients may develop prostate cancer (PCa) within a 5-year period, often not clinically significant. Current guidelines recommend a repeat biopsy within 3–6 months after the initial diagnosis, but it seem not to be the best strategy. Methods: Objectives—evaluating the natural history of ASAP, stratifying the risk of csPCa after ASAP, identifying predictive factors of PCa after atypical diagnosis. Materials and methods—retrospective single-institutional study on patients undergoing prostate biopsy for suspicious PCa (2005–2016). We evaluated the incidence of overall PCa, intermediate-high risk of PCa and csPCa in case of ASAP, according to D’Amico classification and Epstein modified criteria. Results: Out of 4.567 patients undergoing prostate biopsy, ASAP was detected in 2.6% of cases. All patients with ASAP underwent repeat saturation biopsy within 6 months and PCa was diagnosed in 34.5%. According to D’Amico classification, 26%, 5.9%, and 2.5% had low, intermediate, and high-risk disease, respectively. According modified Epstein criteria, the incidence of csPCa was 12.6%. LRT showed that the overall probability to develop PCa doubled when PSA density (PSAD) moved from values lower than 0.13 ng/ml/cc to class 0.13–0.30 ng/ml/cc, and it tripled when PSAD was higher than 0.30 ng/ml/cc. Conclusions: The rate of csPCa in patients with an initial diagnosis of ASAP who had repeat biopsy was 12.6%. The overall PCa rate was 34.5%. Among patient undergoing RP, an upgrading from ncsPCa to csPCa was reported in 35% of cases. PSAD is the only predictive factor directly associated to the risk of developing PCa on repeat biopsy. These findings suggest that immediate repeat biopsy remains the correct strategy in absence of novel predictor factors and non-invasive diagnostic evaluations.

scholarly journals Atypical Small Acinar Proliferation: Repeat Biopsy and Detection of High Grade Prostate Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Andrew Leone ◽  
Katherine Rotker ◽  
Christi Butler ◽  
Anthony Mega ◽  
Jianhong Li ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Prostate Biopsy ◽  
Repeat Biopsy ◽  
Gleason Grade ◽  
High Grade ◽  
Atypical Small Acinar Proliferation ◽  
Prostate Biopsies ◽  
Significant Difference ◽  
Initial Biopsy

Purpose. Atypical small acinar proliferation (ASAP) is diagnosed in 1-2% of prostate biopsies. 30–40% of patients with ASAP may be diagnosed with prostate cancer (PCa) on repeat biopsy. Our objective was to examine the association between ASAP and subsequent diagnosis of intermediate/high risk PCa.Materials and Methods. Ninety-six patients who underwent prostate biopsy from 2000 to 2013 and were diagnosed with ASAP were identified. Clinicopathologic features were analyzed. Comparison was made between those with subsequent PCa on repeat biopsy and those with benign repeat pathology.Results. 56/96 (58%) patients had a repeat biopsy. 22/56 (39%) were subsequently diagnosed with PCa. There was no significant difference in patients’ characteristics. Presence of HGPIN on initial biopsy was associated with a benign repeat biopsy (68% versus 23%). 17/22 (77%) had Gleason grade (GG) 3+3 disease and only 5/22 (23%) had GG 3+4 disease.Conclusions. 22/56 patients (39%) of patients who underwent a subsequent prostate biopsy following a diagnosis of ASAP were found to have PCa. 77% of these men were diagnosed with GG 3+3 PCa. Only 23% were found to have intermediate risk PCa and no high risk PCa was identified. Immediate repeat prostate biopsy in patients diagnosed with ASAP may be safely delayed. A multi-institutional cohort is being analyzed.

Atypical Small Acinar Proliferation in the Prostate: Clinical Significance in 2006

2006 ◽  
Vol 130 (7) ◽  
pp. 952-957 ◽  
Author(s):  
David G. Bostwick ◽  
Isabelle Meiers
Keyword(s):  
Prostate Cancer ◽  
Clinical Significance ◽  
Needle Biopsy ◽  
Invasive Carcinoma ◽  
Repeat Biopsy ◽  
Prostate Needle Biopsy ◽  
Atypical Small Acinar Proliferation ◽  
Biopsy Specimens ◽  
Diagnostic Threshold

Abstract About 2% of contemporary prostate needle biopsy specimens contain collections of small acini that are suspicious for cancer but that fall below the diagnostic threshold and are reported as atypical small acinar proliferation suspicious for but not diagnostic of malignancy. Prostate cancer has been identified in specimens from subsequent biopsies in up to 60% of cases of atypical small acinar proliferation, indicating that this finding is a significant predictor of cancer. Identification of atypical small acinar proliferation warrants repeat biopsy for concurrent or subsequent invasive carcinoma.

Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

2008 ◽  
Vol 19 (3) ◽  
pp. 770-778 ◽  
Author(s):  
Alexandre Ben Cheikh ◽  
Nicolas Girouin ◽  
Marc Colombel ◽  
Jean-Marie Maréchal ◽  
Albert Gelet ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Repeat Biopsy ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri
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