Are malignant cells displaced by large-gauge needle core biopsy of the breast?

OBJECTIVE. The purpose of this paper is to determine the rate of tumor disp lacement resulting from large-gauge needle core biopsy in patients with bre ast carcinoma. MATERIALS AND METHODS, Three hundred fifty-two cancer excisions in patients who had undergone large-gauge needle core biopsy were evaluated for eviden ce of tumor displacement. Three needle procedures were compared: vacuum-ass isted, automated gun, and core biopsy guided by palpation. Needle track vis ualization, presence and amount of tumor displacement, tumor morphology, an d interval between core biopsy and surgical excision were recorded far each case. RESULTS. Seventy-six cases showed tumor displacement of one or two cell clu sters, and 38 cases showed displacement of multiple tumor fragments. Tumor displacement was identified in 37% of automated gun specimens, 38% of speci mens obtained with palpable guidance, and 23% of specimens obtained with a vacuum-assisted needle. Tumor displacement was seen in 42% of patients with an interval between biopsy and excision of less than 15 days, in 31% of pa tients with an interval of 15-28 days, and in 15% of tumors excised more th an 28 days after core biopsy (p < .005). CONCLUSION. Tumor cell displacement was observed in 32% of patients who had undergone large-gauge needle core biopsy. The incidence and amount of tumo r displacement was inversely related to the interval between core biopsy an d excision. This relation suggests that tumor cells do not survive displace ment.