{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:18:59Z","timestamp":1787649539640,"version":"build-2736575974"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In the era of increasing prostate needle core biopsy (PNCB) burden with extended core and MRI-guided biopsies, recommendations are limited on how many histologic levels are needed to identify prostate cancer parameters. Many institutions, including ours, have utilized up to 6 levels. Our quality improvement study evaluates undetected prostate cancer parameters and cost\/time savings when reducing to 3 levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-eight PNCB series (204 individual PNCB) with prostate cancer were identified from 74 consecutive series (614 individual PNCB). Six levels placed on 2 slides were reviewed. Detection of prostate cancer, secondary Gleason patterns, extraprostatic extension, perineural invasion, and atypical small acinar proliferation (ASAP) were compared between the original 6 levels and a simulated reduction to 3 levels using 3 methods: 1) 3-level spanning most of the tissue block, 2) 3-level spanning the superficial block, and 3) 3-level spanning the deep block. Laboratory costs and microtomy\/embedding time data were analyzed to determine savings following change to a 3-level protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The simulated 3-level method spanning most of the block identified all cancer foci and parameters originally detected with 6 levels, except one focus of ASAP (N\u2009=\u200913). Small cancer foci (&lt; 1\u2005mm) and associated parameters were occasionally undetected when only 3 superficial or deep levels were reviewed. Switching to a 3-level cutting protocol saved $9134 over 6 months and reduced microtomy\/embedding time by 9.7\u2005min per 12-part PNCB series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At our institution, evaluating 3 levels spanning most of the block conserves resources while adequately detecting prostate cancer parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10668969251391822","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T16:51:16Z","timestamp":1765903876000},"page":"669-677","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of a Limited Number of Histologic Levels in Prostate Needle Core Biopsies: Do Clinically Significant Cancer Parameters Go Undetected?"],"prefix":"10.1177","volume":"34","author":[{"given":"Rosemary","family":"Mattaino","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA"},{"name":"Larner College of Medicine, University of Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Cortright","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Balla","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA"},{"name":"Larner College of Medicine, University of Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Kida","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA"},{"name":"Larner College of Medicine, University of Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abiy","family":"Ambaye","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA"},{"name":"Larner College of Medicine, University of Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5876-3981","authenticated-orcid":false,"given":"John M.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA"},{"name":"Larner College of Medicine, University of Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Cancer of the Prostate - Cancer Stat Facts. 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