Performance of Needle Biopsy of the Prostate for Men with Suspected or Established Prostate Cancer

Guideline Objective

This recommendation report addresses “best practices” for prostate needle biopsies and provides guidance on the spectrum of prostate needle biopsy practices, including patient preparation, biopsy techniques, specimen submission to the laboratory, processing of the biopsy specimen, information to include on the requisition and pathology report, and operational issues. Indications for prostate needle biopsy are outside the scope of this document.

The report aims to reduce variability in practice across the province, optimize needle biopsy technique and processing, and improve patient care.

Patient Population

Men with suspected prostate cancer and those with prostate cancer who are being followed in an active surveillance program.

Intended Guideline Users

Providers involved in any aspect of prostate biopsy practices, including urologists, radiologists, radiation oncologists, pathologists and individuals responsible for ensuring necessary resources.

Research Questions

1. Who should order prostate needle biopsies?
2. What is the optimal pre-biopsy preparation and peri-biopsy management for patients having a prostate needle biopsy, including: patient consent, management of patients on antiplatelet and anticoagulant medication, bowel preparation, antibiotic prophylaxis and analgesia?
3. What is the optimal prostate needle biopsy technique?
4. How should the biopsy specimen be submitted to the laboratory?
5. What is the optimal pathology processing technique and reporting?
6. What expertise should individuals have who perform prostate needle biopsy?
7. What are the necessary facility requirements to perform prostate needle biopsy?