For decades, advocacy groups, medical health professionals and cancer specialists have stressed the impact of early detection on cancer survival rates. While some of the data has come under scrutiny in recent years, specialists continue to refine screening techniques. In the area of prostate cancer biopsies, the traditional sextant technique has given way to more comprehensive techniques that are showing greater detection rates over all.
Function
Screening for prostate cancer begins with a serum test to analyze prostate-specific antigens, but the test has a low degree of specificity. This means that in order to make a diagnosis, at-risk patients with serum levels that cause concern must undergo a biopsy to identify the presence of cancerous cells. The sextant biopsy was the standard technique until the very late 1990s and early 2000s when a few new methods showed promising results.
Features
The sextant technique takes prostate tissue samples transrectally from the upper, middle and lower lobes of the gland. Cores are drawn from the left and right sides of each lobe systematically under the guidance of an ultrasound.
Five-region Alternative
The sextant biopsy is sometimes augmented with additional cores drawn regionally across the prostate, resulting in more material for analysis and fewer repeat tests. The five-region biopsy is one such method drawing a series of cores from the far lateral left, mid, and far lateral right regions of the gland in addition to the two lateral regions covered by the sextant technique. The five-region technique adds seven cores to the six drawn in by the standard sextant technique.
Ten-core Alternative
The 10-core technique is a replacement for the sextant method similar to the five-region biopsy in that it draws cores from the far lateral lobes of the prostate. Doctors draw two cores from each far lateral lobe combined with the six drawn from the sextant regions for a broader look at the tissue overall.
Warnings
Both the 10-core and the five-region biopsies demonstrate better detection rates than the sextant technique alone, but they have higher complication rates than even multiple sextant procedures, according to a study by M. Maffezzini, et al, published in the Italian journal "Archivo Italiano di Urologia" in June 2005. Additionally, older patients are more likely to see detection rates consistent with tests that use more cores but without the additional risk of complications.
