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Q: Spread of breast cancer through surgical biopsies ( Answered 5 out of 5 stars,   2 Comments )
Question  
Subject: Spread of breast cancer through surgical biopsies
Category: Health > Women's Health
Asked by: brendarn-ga
List Price: $20.00
Posted: 29 Nov 2004 09:38 PST
Expires: 29 Dec 2004 09:38 PST
Question ID: 435570
Some women believe that breast cancer can be spread through surgical
biopsies and thus don't want to have them done.  Can you provide
research data to refute this belief and that we can use to educate
women to the contrary?  Thanks, BD

Request for Question Clarification by pinkfreud-ga on 29 Nov 2004 12:34 PST
How technical do you want the data to be?

Are you looking for medical abstracts, like this one?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15477859

Or would something like this be more appropriate?

"With some types of tumors, such as tumors of the ovary or pancreas,
it is possible for a needle to carry a malignant cell to another area.
But this is not a concern in breast cancer. Breast cancer cells do not
seem to be able to live independently unless they are biochemically
ready to do so. This means that a core biopsy - or any other type of
biopsy procedure - will not spread the cancer to other areas."

http://www.susanlovemd.org/faq/biopsy/biopsy_3.html

Clarification of Question by brendarn-ga on 30 Nov 2004 05:58 PST
Both would be helpful.  The second one is especially good for lay
people. Concise and easy to understand.  Info I'm looking for needs to
be appropriate for lay people and health care providers as well. 
Thanks.

Request for Question Clarification by pinkfreud-ga on 30 Nov 2004 12:03 PST
I believe I'll be able to locate the kind of material you need, but
it's good to know in advance what your expectations are. How many
citations would constitute a fully satisfactory answer?

Clarification of Question by brendarn-ga on 01 Dec 2004 06:10 PST
I think 4-5 citations should be plenty.  Thanks, BD
Answer  
Subject: Re: Spread of breast cancer through surgical biopsies
Answered By: pinkfreud-ga on 01 Dec 2004 12:47 PST
Rated:5 out of 5 stars
 
I have gathered some online quotes for you. Most of these refer
specifically to breast cancer; all support the belief that biopsies
are not likely to cause cancer to spread.

======================================================================

"With some types of tumors, such as tumors of the ovary or pancreas,
it is possible for a needle to carry a malignant cell to another area.
But this is not a concern in breast cancer. Breast cancer cells do not
seem to be able to live independently unless they are biochemically
ready to do so. This means that a core biopsy - or any other type of
biopsy procedure - will not spread the cancer to other areas."

Susan Love, M.D.: Frequently Asked Questions
http://www.susanlovemd.org/faq/biopsy/biopsy_3.html

======================================================================

"There are a number of different kinds of biopsies, each useful in
some cases. To get the right diagnosis, and then the right treatment,
it's critical to have the right biopsy done. Here's why: Let's say
that a round teaspoonful of cookie dough represents breast tissue and
that a small frozen pea represents the suspicious area that is needed
for biopsy. Now put the two next to each other and roll them together
until the pea disappears inside the ball of dough. It is impossible to
see where the pea is located. It might be in the middle, off to the
side, or somewhere in between. If you take a hollow needle, such as
one that is commonly used in a biopsy, and put it into the dough, you
will get something in the hollow of the needle - it might be a piece
of the pea or it might just be cookie dough. It might be necessary to
take multiple samples with that hollow needle before you find the pea.

This illustrates the importance of getting several biopsy samples from
different parts of the tissue specimen. If you just test one area, you
may miss important cells and misdiagnose the problem as a result.

Also, some important reassurance: biopsy surgery cannot cause breast
cancer to spread."

Understanding DCIS: Getting a Biopsy
http://www.dcis.info/biopsy.html

======================================================================

"In most cases, if it is possible, a needle biopsy is preferred over a
surgical biopsy as the first step in making a cancer diagnosis. A
needle biopsy provides a diagnosis quickly and with little discomfort.
In addition it gives the woman a chance to discuss treatment options
with her doctor before any surgery is done. There is no danger that
the needle biopsy itself will spread the breast cancer. In some
patients, a surgical biopsy may still be needed to remove all or part
of a lump for microscopic examination after a needle biopsy has been
done, or it may be necessary to do a surgical biopsy instead of needle
biopsy."

National Comprehensive Cancer Network Diagnosing Breast Cancer
http://www.nccn.org/patients/patient_gls/_english/_breast/3_work-up.asp

======================================================================

"Having a biopsy is usually the only way to make sure whether or not
abnormal tissue is cancerous and so it is a very important test.

People are often concerned that a biopsy may cause cancer to spread
but there is no convincing evidence that having a biopsy of a cancer
causes the growth to spread, or worsens the outlook in any way. Given
this lack of risk and the importance of the information the biopsy can
give it is something you should definitely go ahead with."

CancerBACUP: Q & A
http://www.cancerbacup.org.uk/QAs/AboutcancerQAs/TestsinvestigationsQAs/Biopsy/related_faqs/QAs/783

======================================================================

"A biopsy means taking a small sample of tissue from the body for
examination under the microscope.

This may involve a relatively simple procedure where a needle is used
to withdraw the sample (this is usually done under a local
anaesthetic, often as an out-patient). Or it may need a small
operation (done under a general anaesthetic, often as a day-patient).

For the great majority of cancers a biopsy is essential to confirm the
diagnosis. The tests done on the tissue from the biopsy also give
doctors important information about the cancer and how it should be
treated.

Although a biopsy does always involve some disturbance of the
suspected cancer there is no evidence that the test increases the risk
of spread of the cancer."

CancerBACUP: Q & A
http://www.cancerbacup.org.uk/QAs/AboutcancerQAs/TestsinvestigationsQAs/Biopsy/related_faqs/QAs/512

======================================================================

"The conclusion, based on the present data, is that preoperative
breast biopsy does not cause artificial tumour cell spread to the SLN,
with possible negative impact on the prognosis of breast cancer."

PubMed: The impact of preoperative breast biopsy on the risk of
sentinel lymph node metastases: analysis of 2502 cases from the
Austrian sentinel node biopsy study group.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15477859

======================================================================

"Experts: Breast Cancer Not Spread by Biopsy...

Women whose breast cancers have spread to their lymph nodes are more
likely to have had their cancer diagnosed by needle biopsy.

What the finding means isn't at all clear. But what it doesn't mean is
very clear indeed, says Nora M. Hansen, MD, assistant director of the
Joyce Eisenberg Keefer Breast Center at the John Wayne Cancer
Institute in Santa Monica, Calif.

'This study does not link biopsy with spread [of breast cancer],'
Hansen tells WebMD via email."

WebMD: Breast Cancer Not Spread by Biopsy
http://aolsvc.health.webmd.aol.com/content/article/89/100302.htm

======================================================================

"Would multi-stage surgeries contribute to the spread of cancer?

No. Neither do needle biopsies. 'Multi-stage' refers to the practice
of performing one surgery at a time, for example, first the biopsy
would be performed and then the mastectomy or lumpectomy would be
performed at another time. Multi-stage surgeries can sometimes lead to
more information and better decision making."

CancerLynx: Frequently Asked Questions About Breast Cancer 
http://www.cancerlynx.com/breastfaq.html

======================================================================

"Q:  Has it been proven that there is any correlation at all between
mammography and cause and effect in breast cancer? Also, can a core
biopsy cause an already present malignancy to spread, especially
something that is confined inside a membrane such as the in situ
cancers? Can the biopsy itself release cancer cells to spread?
  
 A: There is no correlation between mammography (radiation from this
type of xray) and getting breast cancer. It is used as an excuse by
some women wanting to avoid getting one though. Regarding your second
question, Core biopsy does not spread the mailgnancy in the breast."
 
The Breast Center at Johns Hopkins: Ask an Expert
http://www.hopkinsmedicine.org/breastcenter/team/askexpert/index.cfm?cat=26

======================================================================

"The proper performance of an incisional or needle biopsy does not
increase the rate of metastasis."

Overview of Biopsy Principles and Surgical Oncology
http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00176.htm 

======================================================================

"Does a surgical biopsy cause a cancer to spread? The answer in nearly
all cases is, 'No.' A few types of cancers do have the potential to
spread into the surgical wound when an incisional biopsy is done,
however, this is quite uncommon... So, surgeons doing such a biopsy
must be certain that the skin surrounding the biopsy site is in a
location that can later be completely removed as part of the follow-up
operation to remove the entire cancer. It is commonly believed by the
public that a tumor will spread if it is exposed to air during
surgery, or that the cancer will grow more rapidly if it is removed;
these are only myths and have no basis in fact."

Texas A&M University: How is cancer diagnosed?
http://www.cvm.tamu.edu/oncology/faq/questions/diagno01.html

======================================================================

"James Nethery, M.D...

Will a biopsy cause cancer to spread?

In almost all cases, a biopsy will not cause cancer to spread."

California State Polytechnic University, Pomona: Biology of Cancer Homepages
http://www.csupomona.edu/~cancerbio/oral%20cancer%20-%20Dr.%20Nethery.htm

======================================================================

"Biopsy may be done with the help of needle (FNAC) or by taking
directly from the tumor with sharp cutting instruments. A tiny sample
is sufficient to arrive at a diagnosis. Can biopsy cause cancer to
spread? No. A malignant tumor will spread whether biopsy is taken or
not. But it is usually advised that the least traumatic technique be
employed to take the biopsy."

Cancer Help: DETAILS OF DIAGNOSIS OF CANCER 
http://www.cancerhelp4u.com/diagnosis.htm

======================================================================

"Transcript of live chat with Sameer Kaul, Oncologist...
Some believe that putting a knife to cancer (biopsy) may spread it -
on the contrary, biopsy is the only 100 per cent sure way of
diagnosing cancer."

India Times: Sameer Kaul
http://tweens.indiatimes.com/articleshow/42170979.cms

======================================================================

"Biopsy has to be performed in the operating room and require general
anaesthesia. It does not cause any spread of cancer."

Indian Society of Head & Neck Oncology: Larynx Cancer
http://www.ishno.com/lardia.htm

======================================================================

"Will the biopsy itself cause the spread of cancer along the track of the needle?

Despite the performance of hundreds of thousands of biopsies, this
theoretical possibility has not been convincingly reported in the
literature."

MyThyroid: Nodules
http://www.mythyroid.com/nodules.htm

======================================================================

I hope this will be helpful. If anything is unclear or incomplete,
please request clarification; I'll be glad to offer further assistance
before you rate my answer.

Best regards,
pinkfreud
brendarn-ga rated this answer:5 out of 5 stars and gave an additional tip of: $10.00
Researcher did a very nice job, provided information requested with
resources sited so I can have info for future searches. Very pleased
with results.

Comments  
Subject: Re: Spread of breast cancer through surgical biopsies
From: pinkfreud-ga on 02 Dec 2004 09:52 PST
 
Thank you very much for the five stars and the nice tip!

~pinkfreud
Subject: Re: Spread of breast cancer through surgical biopsies
From: dkapoor-ga on 12 Jun 2005 17:38 PDT
 
It does spread based on what kind of cancer it is and what is
performed. The case in example is as follows... Oncologist conducts a
blind FNA (fine needle, blindly jabbed (not guided) into the breast 6
to 8 times, as I stand horrified and watch). The ultrasound showed the
tumor to be about 1.2 cm. This happened on a Tuesday. On Thursday,
another ultrasound puts the size at 1.4 cm appx with one lymph node
involvement. Friday, core biopsy is conducted on breast tumor and FNA
on one lymph node. Ultra sound confirms size to be 1.4 cm and one
lymph node present. The trauma from this core biopsy to the breast is
severe. The large hard trauma mass could be felt in a few days.
Following Sunday (8 days) MRI shows tumor to be 9.9 cms and multiple
Lymph nodes, which the cancer board tries to discredit. That is
BULLSHIT. Modern Medicine tries to cover for their butchery and
ignorance with false assurances. If surgery happens within a week,
none of the truth comes out and ingnorance continues on. Telling
people that jabbing of these needles into a tumor mass will not carry
any of these cells into vascular space is absurd.

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