What is an ASAP in prostate checks?

When performing a biopsy of the prostate, one of the possible outcomes is the identification of a ASAP (from the English “Atypical Small Acinar Proliferation”).

This term is used by pathologists to describe a small group of atypical prostate glands that may represent reactive features, benign (non-cancerous) entities or a low-grade prostate cancer.

ASAP is a lesion of prostate tissue that the pathologist identifies by exclusion. It consists of prostate cells arranged in clusters of small acini with an atypical appearance.

The characteristics of this lesion share some aspects with those of cancer cells, but the atypical features present are not sufficient for a definitive diagnosis of cancer. Therefore, the analogy with cancer cells is partial, as there are differences that make ASAP a distinct pathology.

An ASAP biopsy result is not a diagnosis of prostate cancer. However, it could be an indication that a tumour is present nearby or in areas of the prostate that were not sampled.

The presence of ASAP requires further evaluation, as it is not sufficient to establish a definitive diagnosis of prostate cancer, nor to exclude it.

What to do after an ASAP biopsy result?

After an ASAP biopsy result, the most common recommendation is to perform a new biopsy. This is because about 31% of men diagnosed with ASAP will turn out to have prostate cancer when the biopsy is repeated.

However, most of these tumours are low-grade (Gleason 6) and small, which means they are less likely to cause serious damage.

An ASAP biopsy result requires careful evaluation and follow-up. The decision on when to repeat the biopsy will depend on various factors, including levels of PSA, general health and risk factors for prostate cancer.

It is essential to discuss with your doctor to determine the best plan of action.