Can a biopsy make my cancer spread?

You might have heard that biopsy procedures cause cancer to spread. We will examine the evidence and discuss the risks and benefits of this procedure in this article.

What are Biopsies?

A biopsy is a procedure in which a small sample of cells or tissue is taken from the tumour. It is then examined by a pathologist under a microscope for the presence of cancer cells. A pathologist is a doctor who specializes in interpreting cancer cells and tissues. A biopsy is done to make a conclusive diagnosis of cancer.

Why do I need a biopsy?

A biopsy allows doctors to accurately diagnose cancer and determine the best course of treatment. Without a biopsy, it can be difficult to accurately diagnose cancer and determine the best treatment plan.

Do we always need a biopsy?

Conventionally, cancers of the gastrointestinal tract (oesophagus, stomach, and colorectal cancers) are always biopsied, as the biopsy can be obtained endoscopically. There is no risk of tumour seeding in an endoscopic biopsy. A biopsy is not always required for the treatment of other cancers. Especially, if surgery is the first step in the treatment and the diagnosis can be made on CT, MRI or PET scan. For example, suspected gallbladder, pancreatic and liver tumours do not always require a biopsy before surgery.

How do we do a Biopsy?

There are several ways in which we obtain the biopsy when required. The exact technique depends on the location and type of cancer. If the cancer is detected in the gastrointestinal tract such as the oesophagus, stomach, duodenum, colon, or rectum; a biopsy is done endoscopically. Trucut biopsy and fine needle aspiration cytology (FNAC) obtain a sample when the malignancy develops in other solid organs such as the liver, gallbladder, and pancreas.

Fine needle aspiration cytology (FNAC) is a minimally invasive procedure in which a thin, hollow needle is inserted into a suspicious area to collect a small sample of cells. Trucut biopsy is a procedure that involves the use of a specialized needle or device to remove a small core of tissue from a suspicious area for examination.

What is the risk of a biopsy?

Potential risks of a biopsy depend on the specific type of biopsy being performed and the location of cancer. For example, some biopsy procedures may carry a risk of bleeding or infection, while others may have the potential to damage nearby tissues or organs.

What we are discussing here is the risk of cancer spread. Theoretically, the needle used to collect a biopsy sample could dislodge and spread cancer cells, leading to the growth of new tumours along the needle's track. This is called tumour seeding or needle seeding.

Tumour seeding or needle seeding is a rare occurrence that has been reported in some case studies. However, this risk is extremely small and is outweighed by the benefits of the procedure if genuinely required. Most of the research has found that the risk of tumour seeding during a biopsy is low. The risk of cancer spreading because of a biopsy is far less than the risk of cancer spreading without a biopsy and treatment.

What does the research say about biopsies spreading cancer?

Overall, the evidence from various studies and reports suggests that the risk of tumour seeding during a biopsy is low and that the benefits of biopsies outweigh the risks. A review of studies published in 2015 found that the incidence of needle-track seeding was less than 1%. In a 2015 study in Gut, the researchers found that biopsies were not associated with an increased risk of dying in patients with pancreatic cancer. Rather, a biopsy was marginally associated with improved overall survival. Other studies, such as those conducted in patients with pancreatic and bladder cancer, have also found that biopsies do not significantly increase the risk of cancer spread.

Overall, while it is not impossible for needle seeding to occur during a biopsy, it is rare.

Why is it important to get a recommended biopsy?

A biopsy is often the best way to definitively say whether you have cancer. Other tools, such as ultrasound, magnetic resonance imaging (MRI), and PET-CT scans can tell the doctor if an area looks suspicious. But in most cases, the only way to make a definitive cancer diagnosis is to perform a biopsy.

Sometimes, a biopsy reveals that the suspicious area contains only benign, or non-cancerous, cells. This might mean you do not need treatment, such as surgery, radiation therapy, or chemotherapy. A biopsy can also explain what type of cancer cells are inside the tumour. Other times, a biopsy can tell the doctor how aggressive the cancer appears to be and what the extent of the disease may be. This refers to the cancer’s stage and grade. All this information helps determine the best course of action for treating cancer.

So, if your doctor recommends a biopsy, it is important to understand that the procedure may be essential for accurately diagnosing and treating cancer. The risk of cancer spreading because of a biopsy is small, and the benefits of the procedure outweigh any potential risks.

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