From the Guidelines
Biopsies do not significantly disseminate cancer cells, and the risk of needle-track seeding is extremely low, occurring in less than 1% of cases, as reported in a 2020 study published in the Journal of the American College of Radiology 1. When a biopsy is performed to diagnose or rule out malignancy in indeterminate lesions, the overall technical success rate is high, and the benefits of obtaining an accurate diagnosis far outweigh any theoretical risks. Some key points to consider include:
- The technical success rate of biopsies under grayscale US guidance is 74%, which can be increased to 100% under CEUS guidance 1.
- The percentage of tumor cells in the biopsy sample is greater with a higher number of collected biopsy samples 1.
- The risk of postbiopsy bleeding may be as high as 9% to 12%, particularly with hypervascular lesions, but this is a separate concern from cancer dissemination 1.
- In patients with HCC, the rate of seeding is 0.1% to 0.7%, which is a relatively low risk 1. In real-life clinical practice, the decision to perform a biopsy should be based on the individual patient's situation, taking into account the potential benefits of obtaining an accurate diagnosis and the minimal risks associated with the procedure. The use of modern biopsy techniques and careful precautions by cancer specialists and surgeons minimizes any disruption to surrounding tissues and reduces the risk of cancer dissemination. Ultimately, the benefits of biopsy in terms of improving patient outcomes and quality of life outweigh the extremely low risk of cancer dissemination, and biopsies remain a crucial diagnostic tool in the management of cancer patients.
From the Research
Biopsy Procedure and Cancer Cell Dissemination
- The provided studies do not directly address the question of whether a biopsy procedure disseminates cancer cells if malignancy is present 2, 3, 4, 5, 6.
- However, the studies discuss the safety and effectiveness of various biopsy techniques, such as fine-needle aspiration biopsy 2, research biopsies 3, endoscopic biopsies 4, 6, and excision biopsies 5.
- Some studies mention potential complications of biopsy procedures, including blood extravasation-related complications 2, bleeding 4, and infection 2, but do not specifically address the risk of cancer cell dissemination.
- The studies focus on the diagnostic accuracy and yield of biopsy procedures, as well as the importance of proper technique and expertise in performing biopsies 2, 4, 5, 6.
Biopsy Techniques and Cancer Diagnosis
- The studies discuss the use of various biopsy techniques in the diagnosis of cancer, including fine-needle aspiration biopsy for thyroid carcinomas 2, research biopsies for understanding tumor biology 3, and endoscopic biopsies for diagnosing gastrointestinal cancer 4, 6.
- The studies emphasize the importance of proper biopsy technique and expertise in obtaining accurate diagnoses 2, 4, 5, 6.
- Some studies discuss the challenges and pitfalls of differential diagnostic classification of benign and malignant lesions 6, but do not address the question of cancer cell dissemination during biopsy procedures.