Breast Cancer

, Volume 17, Issue 1, pp 61–67 | Cite as

The use of positive core wash cytology to estimate potential risk of needle tract seeding of breast cancer: directional vacuum-assisted biopsy versus automated core needle biopsy

Original Article



A disadvantage of the image-guided core needle biopsy is that needle tract seeding may occur and affect the local recurrence and overall survival rates of patients after breast-conserving surgery, although the chance is small. The purpose of this study was to compare the potential risk of needle tract seeding of breast cancer from ultrasonographically guided needle biopsies that were performed with a directional vacuum-assisted device and an automated core needle gun.


The study compared the biopsies of 148 breast cancers performed using ultrasonographically guided core needle biopsy with the biopsies of 105 breast cancers performed using the vacuum suction probe. The potential risk of needle tract seeding of the breast cancer was defined by the cytological results derived from the needle wash material. The atypical/indeterminate, suspicious/probably malignant, and malignant categories were considered to represent positive cases.


There were significantly fewer positive cytological findings derived from the needle wash material with the directional vacuum-assisted device (33%) than with the automated core needle gun (69%) (P < 0.0001).


The use of the directional vacuum-assisted device significantly decreases the potential risk of needle tract seeding of breast cancer after an ultrasonographically guided needle biopsy.


Breast neoplasm Needle tract seeding Directional vacuum-assisted biopsy Automated core needle biopsy 


  1. 1.
    Liberman L. Percutaneous imaging-guided core breast biopsy: state of the art at the millennium. AJR Am J Roentgenol. 2000;174:1191–9.PubMedGoogle Scholar
  2. 2.
    Parker SH, Klaus AJ, McWey PJ, Schilling KJ, Cupples TE, Duchesne N, et al. Sonographically guided directional vacuum-assisted breast biopsy using a handheld device. AJR Am J Roentgenol. 2001;177:405–8.PubMedGoogle Scholar
  3. 3.
    Diaz LK, Wiley EL, Venta LA. Are malignant cells displaced by large-gauge needle core biopsy of the breast? AJR Am J Roentgenol. 1999;173:1303–13.PubMedGoogle Scholar
  4. 4.
    Liberman L, Vuolo M, Dershaw DD, Morris EA, Abramson AF, LaTrenta LR, et al. Epithelial displacement after stereotactic 11-gauge directional vacuum-assisted breast biopsy. AJR Am J Roentgenol. 1999;172:677–81.PubMedGoogle Scholar
  5. 5.
    Michalopoulos NV, Zagouri F, Sergentanis TN, Pararas N, Koulocheri D, Nonni A, et al. Needle tract seeding after vacuum-assisted breast biopsy. Acta Radiol. 2008;49:267–70.CrossRefPubMedGoogle Scholar
  6. 6.
    Uematsu T, Kasami M. Risk of needle tract seeding of breast cancer: cytological results derived from core wash material. Breast Cancer Res Treat. 2008;110:51–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Uematsu T, Kasami M, Uchida Y, Yuen S, Sanuki J, Kimura K, et al. Ultrasonographically guided 18-gauge automated core needle breast biopsy with post-fire needle position verification (PNPV). Breast Cancer. 2007;14:219–28.CrossRefPubMedGoogle Scholar
  8. 8.
    Developed, approved at the National Cancer Institute-sponsored conference, USA. The uniform approach to breast fine-needle aspiration biopsy. Cytopathology. 1997;16:295–311.CrossRefGoogle Scholar
  9. 9.
    Fitzal F, Sporn EP, Draxler W, Mittlbock M, Taucher S, Rudas M, et al. Preoperative core needle biopsy does not increase local recurrence rate in breast cancer patients. Breast Cancer Res Treat. 2006;97:9–15.CrossRefPubMedGoogle Scholar
  10. 10.
    Chen AM, Haffty BG, Lee CH. Local recurrence of breast cancer after breast conservation therapy in patients examined by means of stereotactic core-needle biopsy. Radiology. 2002;225:707–12.CrossRefPubMedGoogle Scholar
  11. 11.
    King TA, Hayes DH, Cederbom GJ, Champaign JL, Smetherman DH, Farr GH, et al. Biopsy technique has no impact on local recurrence after breast-conserving therapy. Breast J. 2001;7:19–24.CrossRefPubMedGoogle Scholar
  12. 12.
    Knight R, Horiuchi K, Parker SH, Ratzer ER, Frenoglio ME. Risk of needle-track seeding after diagnostic image-guided core needle biopsy in breast cancer. JSLS. 2002;6:207–9.PubMedGoogle Scholar
  13. 13.
    Hoorntje LE, Schipper MEI, Kaya A, Verkooijen HM, Klinkenbijl JG, Rinkes IHMB. Tumor cell displacement after 14G breast biopsy. Euro J Surg Oncol. 2004;30:520–5.CrossRefGoogle Scholar
  14. 14.
    Youngson BJ, Liberman L, Rosen PP. Displacement of carcinomatous epithelium in surgical breast specimens following stereotaxic core biopsy. Am J Clin Pathol. 1995;103:598–602.PubMedGoogle Scholar
  15. 15.
    Stolier A, Skinner J, Levine EA. A prospective study of seeding of the skin after core biopsy of the breast. Am J Surg. 2000;180:104–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Thurfjell MG, Jansson T, Nordgren H, Bergh J, Lindgren A, Thurfjell E. Local breast cancer recurrence caused by mammographically guided punctures. Acta Radiol. 2000;41:435–40.PubMedGoogle Scholar
  17. 17.
    Chao C, Torosian MH, Boraas MC, Sigurdson ER, Hoffman JP, Eisenberg BL, et al. Local recurrence of breast cancer in the stereotactic core needle biopsy site: case reports and review of the literature. Breast J. 2001;7:124–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Uriburu JL, Vuoto HD, Cogorno L, Isetta JA, Candas G, Imach GC, et al. Local recurrence of breast cancer after skin-sparing mastectomy following core needle biopsy: case reports and review of the literature. Breast J. 2006;12:194–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Harter LP, Curtis JS, Ponto G, Craig PH. Malignant seeding of the needle track during stereotaxic core needle breast biopsy. Radiology. 1992;185:713–4.PubMedGoogle Scholar
  20. 20.
    Foote FW Jr, Stewart FW. A histologic classification of carcinoma of the breast. Surgery. 1946;19:74–99.Google Scholar
  21. 21.
    Phelan SM, O’Doherty A, Hill A, Quinn CM. Epithelial displacement during breast needle core biopsy causes diagnostic difficulties in subsequent surgical excision specimens. J Clin Pathol. 2007;60:373–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Boughey J, Gonzalez RJ, Bonner E, Kuerer HM. Current treatment and clinical trial developments for ductal carcinoma in situ of the breast. The Oncologist. 2007;12:1276–87.CrossRefPubMedGoogle Scholar
  23. 23.
    Youngson BJ, Cranor M, Rosen PP. Epithelial displacement in surgical breast specimens following needling procedures. Am J Surg Pathol. 1994;18:896–903.PubMedCrossRefGoogle Scholar
  24. 24.
    Schueller G, Schueller-Weidekamm C, Helbich TH. Accuracy of ultrasound-guided, large-core needle breast biopsy. Eur Radiol. 2008;18:1761–73.CrossRefPubMedGoogle Scholar
  25. 25.
    Schueller G, Jaromi S, Ponhold L, Fuchsjaeger M, Memarsadeghi M, Rudas M, et al. US-guided 14-gauge core-needle breast biopsy: results of a validation study in 1352 cases. Radiology. 2008;248:406–13.CrossRefPubMedGoogle Scholar
  26. 26.
    Fishman JE, Milikowski C, Ramsinghani R, Velasquez MV, Aviram G. US-guided core-needle biopsy of the breast: how many specimens are necessary? Radiology. 2003;226:779–82.CrossRefPubMedGoogle Scholar
  27. 27.
    Wallis M, Tardivon A, Hebich T, Schreer I. Guidelines from the European society of breast imaging for diagnostic interventional breast procedures. Eur Radiol. 2007;17:581–8.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2009

Authors and Affiliations

  1. 1.Breast Imaging and Breast Intervention Section in Breast Center, Department of Clinical PhysiologyShizuoka Cancer Center HospitalShizuokaJapan
  2. 2.Department of PathologyShizuoka Cancer Center HospitalShizuokaJapan

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