Are Breast Biopsies Safe?

Hi there, it's Dr. Jen. You asked and I answered. I have been getting many, many questions about whether or not needle biopsies, minimally invasive breast biopsies, are safe. So I did a lot of research, I looked at a number of papers, looking at this, and I am going to bring my own experience into the discussion because in my career I have performed thousands of these minimally invasive biopsies and treated thousands of women for breast cancer. So I can tell you that my experience lines up very well with what is seen in the literature. And there is no doubt that when you do a biopsy, a minimally invasive biopsy, and that generally means passing a 14 gauge needle, which is a fairly large needle, through the tumor, and either using a spring loaded mechanism to capture some tissue, or using a vacuum assisted device to capture some tissue, you are no doubt spreading cancer cells at that time. You are displacing cancer cells from the tumor to the adjacent tissues. And if you do surgery within two weeks of that biopsy, you are one third of the time going to see those displaced tumor cells. Now, the longer you wait between the time of the biopsy to the time of your surgery, the longer you wait, the less frequently it is that you are going to see those tumor cells, those displaced tumor cells. And that is because those displaced tumor cells are not viable. And what happens is when there is just a couple of them, a few of them that have been displaced by this biopsy process, they don't have an intact blood supply because you've taken them away from their intact blood supply, and they are subject to the immune function of the body. So either they're going to get taken up into the bloodstream or the lymphatics brought to the lymph node, at which time the body will deal with them, or the body is just deal, dealing with them locally. So these displaced tumor cells that happen at the time of biopsy are not viable and are in general not creating any additional issue. So in my practice, having seen thousands and thousands and thousands of women done thousands of these biopsies and followed thousands of women through 20 years of practice, I can tell you I never saw a recurrence in the tract. So where the needle goes into the skin and into the breast and then comes out, I never saw a recurrence in that tract. I never saw a recurrence in the skin where the biopsy was, specifically where the device was introduced into the breast. Whether or not it influences sentinel node positivity or not, I think is going to be very similar to what we see in the adjacent tissues of the breast in that it will displace tumor cells. Without question. Some percentage of those will be taken up in the lymph nodes, but they will only be like small clusters of cells, individual numbers of cells, and they will not create significant disease burden in the nodes. So I do not believe that ultimately biopsying tumors makes them spread. I don't think that it makes you more likely to have a recurrence. I don't think that it makes you more likely to have metastatic disease. Is it traumatic? Certainly. Should people undergo biopsies again and again and again? No. But I do not think that a biopsy used for diagnostic purposes has any long term detriment to how you do with your disease. I don't think that it's going to make it more likely to occur. I don't think that it's going to make it more likely to spread. So and again, I have reviewed a mountain of literature on this and my experience and my personal practice does line up with the literature that I found. It's Dr. Jen, bye for now.