The ability to detect prostate cancer appears to be related more to sites of biopsy than total number of samples taken during procedure, according to an article in the October 3 issue of Journal of the National Cancer Institute.

Researchers at the State University of New York Upstate Medical University performed biopsies on prostates from 164 deceased men who had no history of prostate cancer. Biopsies were taken from various areas of the prostate in an attempt to mirror the way biopsies are performed on live patients.

Eighteen-core biopsies were obtained with six from each of three regions: the mid-peripheral zone, the lateral peripheral zone, and the central zone.

Cancer was found in 47 of the 164 (29 percent) prostates, with 20 clinically significant based on histologic characteristics. Tumor volume correlated with increased age and increased tumor grade.

Biopsies of central zone tissue did not detect any cancers not already identified by biopsies obtained from one or both of the other zones. The sensitivity of the 12 biopsies obtained from the mid-peripheral and lateral peripheral zones was 53 percent. The sensitivity of biopsies from the mid-peripheral zone for clinically significant and nonsignificant cancers was 55 and 11 percent, respectively, compared with 80 percent and 33 percent for the combination of mid- and lateral peripheral zones.

"This information … can assist the clinician to design the appropriate biopsy regimen to detect clinically significant cancers that pose biologic risk and avoid the overdiagnosis of clinically insignificant cancers that would be unlikely to have an adverse effect on the patient,” the authors write.