Q: “Do you have to have a prostate BX to have a clinical T? Patient presented to facility for radiation only. Patient had prostatectomy elsewhere. DRE and imaging noted to be negative. PSA prior to surgery was 7. BX not noted but not clear if it wasn’t done or just not noted in the medical record. Can we assign the T1 based on the negative imaging & DRE or do you have to have a BX?”
A: Only the DRE is used to assign the cT whether apparent or non apparent. If the DRE and imaging are both negative and there is a positive biopsy assign cT1c based on DRE being negative.
Reference Cancer Forum: http://cancerbulletin.facs.org/forums/forum/ajcc-tnm-staging/genitourinary-sites-chapters-40-47/58926-is-prostate-bx-necessary-in-order-to-assign-a-clinical-t?_=1442605891004