A 59-Year-Old Man Is Being Evaluated for Markedly Elevated Prostate-Specific

A 59-year-old man is being evaluated for markedly elevated prostate-specific antigen levels.  He has no bone pain or urinary symptoms.  The patient has no chronic medical conditions or surgical history.  His father died of prostate cancer.  Vital signs are normal.  Digital rectal examination reveals an indurated prostate with no palpable nodules.  The remainder of the examination is normal.  Prostate biopsy is planned.  Which of the following is the best way to obtain a diagnosis in this patient?

A) Cystoscopy guided; multiple random biopsies of the prostate
B) Cystoscopy guided; single biopsy of the central portion of the prostate
C) Transperineal approach; fine-needle aspiration of the prostate
D) Transrectal route; multiple random biopsies of the prostate
E) Transrectal route; single biopsy from the center of the gland

Correct Answer:

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