Lesions missed on prostate biopsies in cases sent in for consultation

Abstract

Although the number of prostate biopsies with missed lesions in a consult-based population of prostate biopsies appears relatively high (2.7%), the detection of the missed lesions would have only effected a definite change in care in 0.5% of all patients or a possible change in care in another 0.5% of patients. Our data underestimates missed lesions, as the entire specimen was not submitted for review in 41% of cases. Although our incidence of missed lesions gives some indication as to the magnitude of the problem, it cannot be equated with the risk of missing lesions in unselected cases.

Error rates in reporting prostatic core biopsies

“…Kronz et al. 10 studied 3251 biopsy cases seen in consultation, and identified 87 (2.7%) patients with missed lesions, including HGPIN, of whom 32 (1%) had prostatic adenocarcinoma. This figure is probably an underestimate, as only selected biopsies were submitted for consultation.…”

“…We have previously published a single-year audit, which used the definition of those cases changed from benign to cancer, and this showed a false-negative error rate of 0.6%, 16 but this larger audit used a broader definition, and as a result found a higher rate of 1.7%. Kronz et al 10 studied 3251 biopsy cases seen in consultation, and identified 87 (2.7%) patients with missed lesions, including HGPIN, of whom 32 (1%) had prostatic adenocarcinoma. This figure is probably an underestimate, as only selected biopsies were submitted for consultation.…”

“…The false‐negative rate is difficult to measure, as a complete review of all negative biopsies is laborious, but targeted audits have shown an error rate of between 1% 10 and 4%, 11 with a recent paper stating 2.4%, 12 although this was dependent on the protocol used. Berney et al.…”

Effects of Homeopathic Preparations on Human Prostate Cancer Growth in Cellular and Animal Models

“…Although detection of the disease is possible at an early stage using either serum prostate specific antigen measurements or biopsies, screening has not been shown to improve survival. 4 Conventional treatments for earlystage disease involve watchful waiting, radiotherapy, and prostatectomy, depending on patient age and comorbidities. In the case of metastatic prostate cancer, androgen suppression remains the treatment of choice after more than 50 years.…”

Reviewing negative prostatic core biopsies for the multidisciplinary team meeting

“…Kronz et al . studied 3251 biopsy cases seen in consultation and identified 87 (2.7%) patients with missed lesions, of which 32 (1%) had prostatic adenocarcinoma 2 . These errors would have changed patient management in 0.5% of all the patients.…”