Was: What's a Mammotome? Now: Needle biopsy as cause of metastasis

From:Abizar Lakdawalla <abizarl@innogenex.com>

Have been hearing some rumbles that needle biopsies increase the incidence of
metastasis. Is this true?

RSRICHMOND@aol.com wrote:

> Jacquie Mack in Canada asks: What's a Mammotome?
> The Fisher Suction Mammotome (that's the correct spelling) is a prone-table
> stereotactic localization device, used to biopsy lesions in the breast seen
> on mammography, either masses or foci of calcification. The patient lies
> prone on a table with her breast hanging through a hole in the table. A
> mammographic X-ray unit finds the lesion, and using this information the
> radiologist or surgeon inserts a biopsy needle into the mass, often
> repeatedly, removing large cores of tissue until the calcification is
> identified by specimen radiography of the cores.
> The cores are immediately fixed in formalin. Some services arrange five
> specimens, a center specimen and the quadrants around it, while other
> services separate cores containing calcifications from the rest. If
> calcifications are sought, the pathologist should receive a specimen
> radiogram, just as would be (or should be) done with a wire localization
> biopsy specimen.
> Sections of these cores usually - there are a number of pitfalls in
> pathologic diagnosis with them - provide an unequivocal diagnosis of cancer
> or benign disease. Immune stains and DNA studies can be done on the core
> specimen.
> The advantages to the patient are obvious. No anesthesia is required, and
> there is no surgical incision or scar. (I have observed a number of these
> procedures, and to the observers eye the procedure does not appear to be
> strikingly painful.) Almost all of the pathologic information needed to plan
> treatment is obtained without anything bigger than a needle biopsy having
> been done to the patient, so that treatment protocols are not compromised and
> the patient has the widest possible choice of treatments.
> Bob Richmond
> Samurai Pathologist
> Knoxville TN

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