Breast Cancer: How Needle Biopsy May Increase Metastases and What May be Done to Reduce Risk Interview with:

Prof. Tanaka

Takemi Tanaka, Ph. D.
Professor, Stephenson Cancer Center
Department of Pathology, School of Medicine
University of Oklahoma Health Science Center What is the background for this study?

Response: Our previous cohort study has shown that breast cancer progresses 60 days after diagnostic biopsy in early-stage ER+ breast cancer. Others have also reported increased breast cancer mortality due to surgery delay. These observations raised the question of how slow-growing ER+ breast cancer progresses so quickly in just 60 days following diagnosis, prompting us to hypothesize whether needle biopsy of breast tumors accelerates pro-metastatic changes. What are the main findings?

Response:  There are several findings derived from our team’s multidisciplinary approach. First, using a large cohort of US patients, our epidemiologist and statisticians found a steep increase in breast cancer mortality emerging 54 days after diagnostic biopsy.

Second, the pathology team identified a unique histology of sustained accumulation of pro-tumorgenic, pro-metastatic M2-like macrophages around the biopsy wound.

Third, our translational researchers identified that needle biopsy of breast tumors increases metastasis, but this can be mitigated by certain types of NSAID. How might NSAIDS limit this effect?

Response: Our data showed that oral administration of COX-2 selective NSAID prevented biopsy-related disease progression in mice. We believe that COX-2 selective NSAID reduced COX-2 activity and prostaglandin E2 production, which were what promoted the M2 shift of macrophages. What recommendations do you have for future research as a results of this study?

Response: Our next step is to examine whether COX-2 selective NSAID can be repurposed for the prevention of biopsy-related disease progression in humans. We hope to implement a safe and affordable pharmacologic prevention since the biopsy-to-surgery interval offers clinical merits for patients who need genetic testing, MRI, second opinion, fertility preservation, etc. Is there anything else you would like to add?

Response: Surprisingly, a series of pro-metastatic changes seem to occur in a relatively short period once a breast tumor is biopsied and wounded. Our study emphasizes the importance of timely surgery once diagnosed. Patients should not avoid needle biopsy if recommended by a doctor, as detection of breast cancer at an early stage is one of the most critical survival factors. We do not believe that needle biopsy itself is a problem. Rather, the recent trend in delay of surgery after needle biopsy is a concern, as cancer cells may acquire more aggressive behavior during this period.


Needle biopsy accelerates pro-metastatic changes and systemic dissemination in breast cancer: Implications for mortality by surgery delay
Kameyama et al., 2023, Cell Reports Medicine 4, 101330 December 19, 2023 ª 2023 The Authors.

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Last Updated on February 4, 2024 by Marie Benz MD FAAD