Are there any factors which would lead you away from recommending active surveillance in low risk prostate cancer?

A healthy male with a BrCa mutation

Or

Any male with at least 50% + bxs

Or

The presence of Perineural invasion

Or

PSA density more then 0.30 may be a new indication after the AUA this year

Would prompt a mpMRI and then fusion bx of any PiRADS 3,4 or 5 areas to rule out grade 4 pc