Breast cancer seeding associated with core needle biopsies: A systematic review

Liebens, Fabienne; Carly, Birgit; Cusumano, Pino; Van Beveren, Martine; Beier, Barbara; Fastrez, Maxime; Rozenberg, Serge

doi:10.1016/j.maturitas.2008.12.002

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Volume 62, Issue 2 , Pages 113-123, 20 February 2009

Breast cancer seeding associated with core needle biopsies: A systematic review

Fabienne Liebens
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium
- Corresponding author. Tel.: +32 25353400, 3225067011, fax: +32 25353409.
Birgit Carly
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium
Pino Cusumano
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium
- Breast Unit, CHC Saint Joseph, Liège, Belgium
Martine Van Beveren
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium
Barbara Beier
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium
Maxime Fastrez
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium
Serge Rozenberg
- Breast Unit, ISALA Breast Cancer Prevention Center and High Risk Clinic Dept OB-Gyn, St. Pierre University Hospital, Haute Str. 290, B-1000 Brussels, Belgium

Received 2 October 2008; received in revised form 30 November 2008; accepted 1 December 2008. published online 29 December 2008.

Abstract

Background

Preoperative diagnosis has become the standard in breast cancer (BC) management. Recently, ultrasound guided core needle biopsy (CNB) and stereotactic needle core biopsy have replaced fine needle aspiration cytology. Epithelial cell displacement (DE) occurs frequently after core needle biopsy (CNB) for breast cancer diagnosis.

Aim

Systematically review (between 1900 and 2008) the clinical significance of DE after CNB in BC patients, and associated risk factors (delay between biopsy and surgery, needle passes, duration of the procedure, tumor size, histological type, tumor grade, margins, type of surgery, and of adjuvant treatment).

Materials and methods

We selected 15 studies: 9 assessed the rate of DE after CNB and 6 the impact of CNB on outcome endpoints.

Results

We found 3 prospective and 12 retrospective studies. However these had numerous biases such as insufficient power, confounding factors, selection of cases and controls, surrogate endpoints, heterogeneity of measured displacement. Malignant DE on surgical specimens occurred in 22% of the patients. A short interval between CNB and surgical excision increased the risk of detecting displaced cells. No increase in local recurrence was reported after CNB. Contradictory results were found in terms of sentinel node metastases. Only one study evaluated overall survival data and reported no worse survival in patients with preoperative CNB.