Lots of men are facing decisions as to how to proceed with their potential diagnosis of PCa...many have had 3+3 Biopsies...I am way beyond this phase of my PCa progression but always find it helpful to look back at decisions I made, see how they came out and where I made errors, determine how to proceed going forward...in the case of my Biopsy I followed the 'Combined' approach highlighted in this Grand Rounds presentation...my RP surgical biopsy nevertheless was upgraded but I think this was because the COVID shutdown delayed my surgery by 6 months (in an empty hospital; another story)...
Definitely though, this Grand Rounds does not recommend a Systemic Biopsy alone (standard 12 core)...the numbers and studies just show that it is not accurate and may provide a 'false-negative' diagnosis of 3+3 where there is in fact significant PCa disease present (Gleason 4 and above).
For those who have not decided on biopsy yet this is a good presentation to watch. For those that have and are looking at follow up AS biopsies in the future, this is a really good presentation to watch. Parametric pelvic MRI guided biopsies combined with Systematic 12 core are good...it looks like Transperineal Biopsies with Mapping may be better...take a look...
MRI fusion Biopsy
AS or Surgery? 
