Aggregate size of a sextant biopsy core sample:

In our practice, biopsy tissue core sizes vary by practitioner. Some produce 8 mm cores, and some produce 11-15 mm cores. At best, a core is only as thick or "fat" as 1 mm (the size of the lead in a refillable lead pencil). As calculated below, an exceptional sextant series of 6 cores from a 30 gram gland would only present a total of 0.2% of that prostate gland for processing and analysis under the microscope by the surgical pathologist. How can this be effective?

Prostate cancer has a strong tendency to crop up in several different gland sites, has a heavy tendency to arise in the edges (periphery) of the sides and back (toward the rectum) of the gland, and has a strong tendency to cause PSA to rise as it grows.

So, base-to-apex spaced core biopsies taken through the rectum and aimed along the gland sides tend to "find" the cancer in cases of abnormally increased PSA test results. If the biopsy results are negative for cancer, you should continue to have your situation followed by a knowledgeable medical practitioner (usually a urologist) to see if the DRE becomes abnormal or the PSA continues to rise. This type of regular follow-up is, for us males, like the regular breast exams and mammograms and Pap smears are for females. Remember: negative biopsies do not guarantee that you are free of prostate cancer!