Prior to performing the biopsy, the urologist uses only local anesthetic. The urologist then identifies the tumor on ultrasound. Next, using a specialized ultrasound probe with a built-in needle guide and on-screen needle tracking, the surgeon uses a standard biopsy gun to obtain 3-4 cores from the mass. The patient is then able to return to routine activities on the same day as the biopsy.
After performing office-based biopsy in 52 patients, the UC Irvine group reported a diagnostic rate of 73% and a concordance with final pathology of 100% for primary histology (93% for renal cell carcinoma subtype and 90% for low vs. high Fuhrman grade). Of particular interest, 39% of patients were able to safely opt for active surveillance rather than surgery based on their biopsy results, and no patients with benign pathology on biopsy underwent surgery.
While renal mass biopsy remains a relatively controversial topic, these findings support the growing body of literature that indicates renal mass biopsy is safe, accurate, and can indeed change management strategies.
Presented by: Francis Jefferson, MD, Department of Urology, University of California-Irvine
Co-authors: Zhamshid Okhunov, John M. Sung, Courtney M. Cottone, Roshan M. Patel, Jaime Landman, The University of California, Irvine
Written by: Francis Jefferson, Department of Urology, University of California-Irvine) at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois