Thursday, May 24, 2018

Will my cancer spread after a breast biopsy?

A common patient concern is that biopsies may cause cancer to spread. Many patients ask me if removal of the lump straight away is better.

My answer to the question starts off with an example. If you get transferred  from Chennai to Delhi , would you prefer to land up in Delhi Railway station with family , bags and baggage straight away or would you like to visit the place a couple of times, find out about possible housing, schools and other facilities and then plan to shift the family ?

chennai breast cancer centre

Likewise, before removing the lump we need a diagnosis followed by a clear plan based on the diagnosis and further information. A biopsy removes a bit of tissue by using a specially designed core needle from the suspicious area of the breast. The tissue is then fixed and studied under a microscope to see if cancer is present. This is done with a local anaesthetic.

If it is benign lump, then surgery may not be required at all. Therefore unnecessary surgery and scar on the breast can be avoided.

If the breast lump is cancerous, then it is staged and tested for hormone receptor sensitivity and Her 2 status. We then assess the possibility of preserving the breast and axillary lymph nodes. Surgical plan including breast conservation, sentinel lymph node biopsy and reconstruction are possibilities that can be discussed and decided upfront with best possible results. Repeat surgeries are avoided with good planning and information for further treatment planning is complete and adequate without any undue time delay.

breast cancer biopsy

Does the needle biopsy cause the cancer to spread?


No. this is a myth and studies have shown that needle track seedling or displacement of cancer cells do not increase the risk of recurrence or spread. The chance that surgery or biopsy will cause cancer to spread to other parts of the body is extremely low. Doctors use special methods and take many steps to prevent cancer cells from spreading during biopsies or surgery to remove cancer.

Breast Biopsy is an incredibly important step in the diagnosis for the patient, as having a definitive cancer diagnosis is important in determining and planning the correct treatment for the patient. The potential gain from a breast biopsy outweighs the risks such as discomfort and bruising.

Can a needle biopsy miss a cancer?


A needle biopsy can sometimes miss breast cancer if the needle takes a sample of tissue or cells from the wrong area. Ultrasound or stereotactic guidance is immensely useful to target the correct area. The sample should be fixed immediately in buffered formalin. A delay in fixing or improper fixing can cause diagnostic difficulties.

Sometimes false negative results can occur due to errors in interpretation. If there is a cause for concern about the possibility of a false negative result ( ie ) if the lesion is suspicious on clinical examination and imaging studies , then a repeat biopsy or surgical excision should be carried out.

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