04 Feb Breast Cancer: How Needle Biopsy May Increase Metastases and What May be Done to Reduce Risk
MedicalResearch.com Interview with:
Takemi Tanaka, Ph. D.
Professor, Stephenson Cancer Center
Department of Pathology, School of Medicine
University of Oklahoma Health Science Center
MedicalResearch.com: 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.
MedicalResearch.com: 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.
MedicalResearch.com: 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.
MedicalResearch.com: 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.
MedicalResearch.com: 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. https://doi.org/10.1016/j.xcrm.2023.101330
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Last Updated on February 4, 2024 by Marie Benz MD FAAD