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Problems With Needle Biopsies

Wednesday, 07 Dec 2016 04:45 PM Current | Bio | Archive

My mother was diagnosed with breast cancer some years ago. As happens with many women, she felt a lump during a self-exam and made an appointment with her doctor.

Before she went to the doctor, I advised her not to let them biopsy the lesion.

I take issue with fine needle aspiration being the standard of care when a suspicious lesion is detected.

Studies have clearly shown that poking a needle into cancerous tissue is dangerous because the needle tract can allow the cancer to spread to nearby, and eventually distant, tissues.

This phenomenon is called “needle tract seeding,” as the cancer cells can follow the needle tract as it is removed and spread to different parts of the body.

In fact, fine needle aspiration has been shown to cause tract seeding in cancers of the breast, lung, thyroid, head, and neck.

Localized breast cancer — that is, confined to the breast — does not kill. It is distant metastasis that kills.

Why would anyone perform a procedure that is known to spread cancer?

Researchers published a study showing that patients who underwent fine needle biopsies were 50 percent more likely to experience micrometastasis — spread to the lymph nodes — than patients who had an entire breast cancer tumor removed by excisional biopsy.

When my patients are diagnosed with a suspicious lesion in the breast or any other tissue, I tell them about the potential problems caused by fine needle aspiration.

If at all possible, I suggest they undergo an excisional biopsy instead of fine needle aspiration.

I am aware that there is a downside, as excisional biopsy is more traumatic to a patient and can lead to disfiguration. However, an excisional biopsy won’t lead to a spread of the cancer.

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I take issue with fine needle aspiration being the standard of care when a suspicious lesion is detected.
breast cancer, biopsy, metastasis, thyroid
Wednesday, 07 Dec 2016 04:45 PM
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