Malignant Seeding Following Percutaneous Breast Biopsy: Documentation With Comprehensive Imaging and Clinical Implications

Abstract

The aim of this study was to demonstrate convincing evidence that percutaneous breast biopsy may result in displacement of malignant cells that can initiate tumor growth at a separate anatomic site, other than the index lesion. Two patients with malignancy diagnosed by percutaneous breast biopsy were followed up with subsequent imaging. The observation of displaced cells initiating subsequent malignant growth was compared retrospectively with the previous year's outcomes following percutaneous breast biopsy. Two cases of displaced malignant cells resulting in malignant growth at a separate site along the biopsy needle track were demonstrated by imaging. During the preceding year, 1644 biopsies with 298 malignant results were compared with the outcomes of these two patients, resulting in a 0.7% incidence of malignant seeding. No identifiable factors could be identified to predict under what conditions this iatrogenic complication occurs. Although uncommon, percutaneous breast biopsy can result in malignant seeding, and raises issues regarding informed consent and proper subsequent treatment.

Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study

“…However, prompt diagnosis and immediate pharmacological therapy may prevent such an occurrence. Needle-track tumor seeding after fine needle aspiration biopsy/core needle biopsy is another possible complication as with any other type of needle biopsy, although literature reports are controversial (Diaz et al, 1991;Nyland et al, 2002;Vignoli et al, 2007;Brenner and Gordon, 2011;Klopfleisch et al, 2011). In this small group of patients, we did not see any evidence of tumor spread or recurrence at the site of biopsy.…”

Recurrent breast cancer in the subpectoral space after implant reconstruction

“…It has previously been reported that inflammation can influence breast cancer recurrence , and that seeding through circulating cancer cells likely plays an integral role in the recurrence and metastasis of breast cancer . Recurrence of breast cancer at core needle biopsy skin sites has been previously described , and physiologic seeding of malignant cells may have happened at the time of initial mastectomy and tissue expander placement via a similar mechanism. One study reported perioperative washings of mastectomy sites as cytologically positive for malignant cells in 4% of patients, with risk factors being cutting of the tumor during removal, presence of positive margins, and presence of an extensive intraductal component to the tumor such as was present in this patient .…”

Supraclavicular lymph node incisional biopsies have no influence on the prognosis of advanced non-small cell lung cancer patients: a retrospective study

“…Another problem was that some investigators were concerned that incisional biopsies might increase the risk of cancer cell seeding and dissemination [20, 21]. Pisters et al found that a positive surgical margin was an independent adverse prognostic factor for local recurrence and survival in soft tissue sarcomas [22].…”