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Aggregate
size of a sextant biopsy core sample:
URL for this page = http://www.theeffectivetruth.info/probx.html
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 sites within that gland, 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 in quantity.
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 (1) the DRE becomes abnormal or (2) 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!
Calculation:
6 biopsy cores times 15 mm length per core=90 mm total aggregate
length
length times cross-sectional surface area =
volume
cross-sectional surface area = pie times radius
squared=(3.14)(.5mm)(.5mm)=0.78 square mm
So, 90mm times 0.78 square mm= 70.2 cubic mm of
biopsy tissue, total. (another source estimates that a sextant exam produces 150 cubic
millimeters & that the volume of a typical prostate is 30,000 cubic
millimeters).
A gram of prostate tissue measures exactly one
cubic centimeter (1000 cubic mm).
Therefore, ([70.2 x
1/1000 x 1 g/cubic cm] divided by 30) x 100= 0.2% of gland taken out as biopsy cores!
Yet, the process is very effective at finding cancer in a patient's
gland, especially if the pathologists are truly committed to finding the cancer if any be present
in the core samples. As 2006 begins, we more often see 8-14 cores per
case.
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(posted 11 December 1998; latest update 15 January
2006)
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