I have not seen anyone bring this up on our forum: The topic of using one biopsy to decide on initial treatment.
Any discussion about AS includes advice to have repetitive biopsies, as was the case during my phone consult with Dr Epstein, because the odds of missing a higher-grade tumor is over 30% on the first biopsy.
Well then, if the first biopsy is used by a man for deciding on his treatment, is there not a significant risk of undertreatment for him because the one biopsy missed a higher-grade tumor?
A simplest of examples, in the context of choosing treatment and not AS, wouldn’t the SOC treatment plan materially change for a man, even if all of tumors remained confined within the prostate capsule, if one of four tumors biopsied were 4+3 rather than all being 3+3?
Does this observation suggest that a repeat biopsy be scheduled before having initial treatment when the first biopsy is categorized as low risk and intermediate risk for a man?
Does this observation suggest a repeat biopsy, even more so, when MRI reports identify a PI-RAD4 lesion but the targeted fusion biopsy tissue taken is shown to be benign, because fusion biopsies are known to miss lesions due to fusion-software misregistrations or low tumor volume?