Can a biopsy needle turn a DCIS into invasive cancer?

Posted by dana23 @dana23, Sep 16, 2023

Hi! I’m concerned about the consequences of having a biopsy. I know it is to lower the number of surgeries regarding benign lesions but I wonder:

The definition of DCIS is (according to cancer.org) that “ the cells that line the ducts have changed to cancer cells but they have NOT spread through the walls of the ducts into the nearby breast tissue”

The definition of IDC(according to nationalbreastcancer.org) is that “ Invasive Ductal Carcinoma is an invasive cancer where abnormal cancer cells that began forming in the milk ducts have spread beyond the ducts into other parts of the breast tissue.”

My question is: Can DCIS cells escape to the surrounding area through the hole made by the needle through the duct AND the membrane of the DCIS and turn it into invasive?

Interested in more discussions like this? Go to the Breast Cancer Support Group.

dana23 @dana23

The information obtain from biopsy is very important to determine a treatment plan.

From an article on cancer.net "Can a Biopsy Make My Cancer Spread?"

"Several studies and reports of individual cases confirm that tumor seeding only very rarely occurs, and that the benefits of biopsies far outweigh the risks. "

https://www.cancer.net/blog/2021-03/can-biopsy-make-my-cancer-spread

Laurie

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@dana23 do you have an alternative to biopsy in mind? I don't know of one so am curious.

I had IV treatments next to a woman who had declined biopsy for fear of cancer spreading. Net result, no biopsy, no treatment. Her tumor had broken the surface of skin and she died a few months later, still thinking that a biopsy was too dangerous. True story.

My concerns about biopsy were that it only tests a small part of a tumor, and tumors can be heterogeneous. For me that meant my biopsy showed HER2+ indicating need for chemo, and post-surgical results were HER2-. Also, I believe it is possible that the healing process may have raised my ki67%. Or I like to think so.

Mine was invasive from the start, but pathology showed lymphovascular invasion- in my lymph vessels "focally." So I always wondered if the biopsy had pushed some cells into the lymph vessel there. It is a reasonable concern concerning lab results but probably makes no difference in outcome, I would think. But ask your doc!

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I’m not sure, but I am in the camp that thinks biopsies are good.
One of my masses is purely IDC, and another is a combination of DCIS with a little IDC. So basically a DCIS that has started turning invasive, recently.

I’m scheduled for surgery in October and I hope they can get it all.

I figure the biopsies will be one of the things that will have helped save my life. I don’t know yet what the surgery will show, and whether or not lymph nodes are involved, but I am hoping my life will be saved and I can look back years from now and say, it’s a good thing I had that imaging done and those biopsies done because I am alive today instead of gone.

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I had wondered that myself.
My initial core needle biopsy results came back as Atypical Ductal Hyperplasia. After having that biopsy, it seemed like the mass had changed a bit and become swollen, but that could have been me being paranoid.
I had my Lumpectomy about 3 months later and the whole mass was biopsied. It came back as an extremely rare Invasive Metaplastic Carcinoma AND also intermediate level DCIS.
I am not sure if the biopsy could have made a difference but definitely a great question to ask your doctor!
That being said, I do feel biopsies are an extremely important part of the process so that docs can learn pertinent information and come up with the best treatment plan for us to have.

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Logic tells me that a biopsy clarifies cancer or not. If cancer, treatment is needed. If something new appears because of the biopsy, that will be treated as well. But first you have to clarify what is there. If your biopsy is negative, there's nothing there to spread. If it's positive, now you have facts, and can go from there.

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Hi! I appreciate all your thoughtful responses!
Just to clarify, I’m in favor of all kind of treatments that will save lives, as well as early detection techniques as long as they don’t make your condition worse.

I made my original question to see if anyone has found out if biopsies done to only-DCIS increase the risk of invasion. If that’s the case, it is a useful information to have when the time comes to make a decision for treatment. For example, I found a study that shows a small percentage of women who decided towards skin-sparing mastectomy to later find a recurrence in the skin at the needle entry site.
You can find out more here:
pubmed.ncbi.nlm.nih.gov/16684314/

I’m not against biopsies and I’m not saying they are not useful, but I’d like to know more about the risks, and I would’ve liked for sure that my Doctor informed me about them before performing one.

I will edit my original post to make my question more clear.

Thank you all!

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@mchler73

I had wondered that myself.
My initial core needle biopsy results came back as Atypical Ductal Hyperplasia. After having that biopsy, it seemed like the mass had changed a bit and become swollen, but that could have been me being paranoid.
I had my Lumpectomy about 3 months later and the whole mass was biopsied. It came back as an extremely rare Invasive Metaplastic Carcinoma AND also intermediate level DCIS.
I am not sure if the biopsy could have made a difference but definitely a great question to ask your doctor!
That being said, I do feel biopsies are an extremely important part of the process so that docs can learn pertinent information and come up with the best treatment plan for us to have.

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My tumor changed and enlarged after biopsy as well, but that injury related inflammation from the biopsy itself was gone by the time my other surgery rolled around. Take heart it was probably just your body trying to heal from needle punches.
How are you doing now? Do you have your treatment plan?

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@auntieoakley

My tumor changed and enlarged after biopsy as well, but that injury related inflammation from the biopsy itself was gone by the time my other surgery rolled around. Take heart it was probably just your body trying to heal from needle punches.
How are you doing now? Do you have your treatment plan?

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I am waiting to find out when my next surgery will be. Initially, my surgeon said I had clear margins but after seeing my medical and radiation Oncologists, they both agreed my margins are way too close and more needs to come out. Once that is done, the plan is for 4 weeks of Radiation.

Due to a couple complications/issues with my current surgeon, I decided to get a second opinion of a new surgeon and I see him tomorrow.
So hopefully that goes good and I can have the surgery soon!

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@dana23

Hi! I appreciate all your thoughtful responses!
Just to clarify, I’m in favor of all kind of treatments that will save lives, as well as early detection techniques as long as they don’t make your condition worse.

I made my original question to see if anyone has found out if biopsies done to only-DCIS increase the risk of invasion. If that’s the case, it is a useful information to have when the time comes to make a decision for treatment. For example, I found a study that shows a small percentage of women who decided towards skin-sparing mastectomy to later find a recurrence in the skin at the needle entry site.
You can find out more here:
pubmed.ncbi.nlm.nih.gov/16684314/

I’m not against biopsies and I’m not saying they are not useful, but I’d like to know more about the risks, and I would’ve liked for sure that my Doctor informed me about them before performing one.

I will edit my original post to make my question more clear.

Thank you all!

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very interesting as after my lumpectomy 2yrs later I had recurrence near skin and near scar and probably also near biopsy entry. i asked surgeon if cancer cells could have been left from the needle for the biopsy and she said she’d only seen one such case and it wasnt mine but i still wonder…

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@cashemire

very interesting as after my lumpectomy 2yrs later I had recurrence near skin and near scar and probably also near biopsy entry. i asked surgeon if cancer cells could have been left from the needle for the biopsy and she said she’d only seen one such case and it wasnt mine but i still wonder…

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My situation is exactly like cashemire's...2 tumors appeared along the incision ; ten months later when I had my first follow-up, I was told it was just scar tissue, but it wasn't. Cancer had returned. I am in limbo at the moment.

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