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Needle tract seeding after vacuum-assisted breast biopsy
N V Michalopoulos1, F Zagouri, T N Sergentanis
1Breast Unit, First Department of Propaedeutic Surgery, Hippokratio Hospital, School of Medicine, University of Athens, Athens, Greece.
Background:
A matter of substantial concern regarding all needle biopsy techniques is seeding along the biopsy needle tract.
Purpose:
To assess cell seeding along the needle tract of vacuum-assisted breast biopsy (VABB).
Material And Methods:
The study included 21 patients with ductal carcinoma in situ (DCIS) and 10 patients with invasive ductal carcinoma (IDC) diagnosed by VABB for nonpalpable mammographic lesions. VABB (11G, on a Fischer table) was performed, and the duration of the procedure was measured. After surgery, the whole needle tract was embedded in paraffin blocks, stained with hematoxylin-eosin, and examined by a pathologist.
Results:
Cases with dissemination of cancer cells in the needle tract were not observed (one-sided 97.5% CI 0-10.0%). In 2/31 (6.5%) cases (95% CI 0.8-21.4%), benign epithelial cell displacement was observed, and the duration of VABB was significantly longer in these two cases (52.5+/-3.5 min vs. 42.0+/-4.4 min for cases without benign cell displacement; P = 0.018, Mann-Whitney-Wilcoxon test for independent samples).
Conclusion:
No displacement of malignant cells within the 11G needle tract was documented. Benign cell displacement was associated with longer VABB duration. The phenomenon of tumor cell dissemination along the needle tract is of questionable clinical significance when the treatment guidelines are followed.