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is there an alternative to core biopsy or FNA

I have to have a core biopsy on Thursday, but dont want a needle to puncture what may be cancer for fear of "seeding" spreading the cancer through the holes that the needle makes. See John Wayne research. Is there an alternative for diagnosis...eg MRI or something that could actually diagnose good enough to be cleared or have a lumpectomy?
thanks
Annette
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Avatar universal
A biopsy is the only definitive way to determine the presence or absence of cancer. Just because something "lights up" on an MRI does not mean it is cancer. Examining the pathology of an actual tissue sample is necessary to make the diagnosis.
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Avatar universal
Hi Annette.
There is a risk of needle tract metastasis in doing the biopsy, but this is small compared to the benefit of having a histologic diagnosis.  A diagnosis of breast cancer can only be done through biopsy.
If you do not want to have a core needle biopsy, an alternative is biopsy by frozen section.  In doing frozen section, the specimen is sent immediately to the pathologist for evaluation while the patient waits in the operating room.  If the result shows malignancy, a more radical surgery will be carried out.
Another alternative is doing an excision biopsy.  The entire breast mass is removed and the specimen sent for evaluation.  
You need to discuss the risks and benefits of treatment to your doctor.
Good luck.
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Avatar universal
Thankyou for the information
Your honesty is good
I think we do core biopsy because there is no alternative...and its cheaper than lumpectomy...it's a case of identifying the cancerous patients and getting rid of the non...ones....then dealing with the cancerous patients....and ALWAYS...removing all needle tracks....it is this that I object to....these needle tracks...

I am not a doctor...but am logical....I was lying in bed thinking about this core biopsy...then it suddenly dawned on me that cancerous cells could travel...be dragged down the needle tracks....
I naturally thought...well its a theory of mine...but I will find out that this just could not happen....BUT....found that exactly as I was thinking....seeding can occur....

I want to have non invasive methods to take me to the stage where a wonderful expert looks at the results and says..." In my experience, this really looks like it may be...We will remove it.........or ..........in my experience this does not look much like....we will keep an eye on it...."

I don't think this is much to ask.....
the 50% seeding results shown by the John Wayne foundation on positive carcinomas identified by core biopsy...is not good...and needs either denying or accepting ...
the Institute is at the top it's league however so I don't see how any doctor could poo poo the results.

If you have anything else that would help me make up my mind then PLEASE send the information...
MANY MANY THANKS
Annette

This must be available somewhere????
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Avatar universal
I am wondering why my surgeon said there is no proof of seeding with biopsy.......ugh
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Avatar universal
If there is specific clinical information, please provide a link that shows the information about 50% seeding. That is not what the 2004 report says.
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Avatar universal
hi there
go to the John Wayne research foundation...they have the information
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Avatar universal
I've been all over the site. Except for the 2004 paper about biopsies, I see no information about needle track seeding. I saw nothing about 50% seeding in the 2004 article, and as I mentioned, they came to their own conclusion that breast biopsies are safe, with minimal risk.
Please provide the SPECIFIC link/info from the site so that we can see what you are talking about.
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Avatar universal
I don't mean to be pesky, but with all these ladies having to have biopsies, I really don't want them sitting at home thinking that they have a 50% chance of spreading possible cancer based on some comment you made without a link to real medical clinical data. They have enough to worry about, as do you. If you post "information" about possible scary consequences of diagnostic tests, then you really need to make sure the actual link is directly available so that people can read for themselves. Otherwise it is just adding extra anxiety to an already extremely stressful situation. It is too easy to disseminate incorrect info on the web. We must all be very careful to only provide info that is backed up by actual medical studies and actual links to clinical studies and conclusions.
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Avatar universal
I have looked all over John Wayne Cancer site and can find nothing about "seeding" cancer cells thru biopsy .......my surgeon said thats not true and I would appreciate this documentation since I have just had the biopsy done and have yet to receive my pathology report! It has really added to my considerable stress level  I have to say. The Doctor that commented about its being true could give us some documentation I think too.
Thank You
Madge
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Avatar universal
http://www.docguide.com/news/content.nsf/news/852571020057CCF68525742D0060C157
http://cancerfighter.wordpress.com/2008/05/01/some-dangers-of-biopsies/
News: (pasted from the above web site)
In June 2004, the results of the bombshell Hansen study, “Manipulation of The
Primary Breast Tumor and The Incidence of Sentinel Node Metastases From
Invasive Breast Cancer,” were published in the American Medical Association‘ s
prestigious journal, Archives of Surgery,  revealing that patients undergoing  fine
needle biopsies were 50% more likely to have micrometastases spread to the
sentinel lymph node than those patients having the entire tumor removed for
biopsy.
The implication of this discovery is that a woman without lymph node
involvement,  who
would have been staged at a low level,  now will be staged higher,her disease
considered more advanced, and more aggressive treatment might be
recommended.
Over the years, several researchers have voiced serious reservations about
routine
needle biopsies, but they were mostly ignored by their colleagues. Hansen’s
research team cited their predecessors, and  the research path leads back
several decades. It’s hard to understand why The Archives of Surgery study, which
embodies all of these reservations about needle biopsies, didn’t make the front
page of the New York Times.
http://www.breastcancerchoices.org/faqbiopsies.html
http://www.healingcancernaturally.com/biopsies-surgery-spread-cancer.html
http://www.freerepublic.com/focus/f-chat/1403410/posts
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Avatar universal
Here is a link to one of two other similar studies i found, both with much larger patient samples than the John Wayne study, and they both disagree with the John Wayne findings.

http://www.nature.com/bjc/journal/v91/n10/full/6602205a.html
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Avatar universal
I guess the main problem I have with your info is that you have frightened a lot of women by the way you presented it (without the other studies that don't come to the same conclusion). Women who may be facing breast cancer should certainly be proactive about getting lots of info, and that includes researching possible alternative tests and treatments (the thermography sounds promising), but posting scary select parts of one complicated study, without links until repeatedly asked, and without the other studies to balance it, just causes a big load of stress for all these women. Try for making people aware of possible diagnostic controversies without scaring the bejeezuz out of them.
Things are all relative. One of the anti-needle biopsy doctors recommends just doing excisional biopsies, which are essentially lumpectomies. What are the possible safety consequences for all those women getting put under anesthesia and being operated on? Did you read all the caveats about how to surgically handle tumors to avoid metastases? See, big can of worms. ALL invasive procedures have risks, so being informes and a little bit skeptical is a good thing. I just want you to be fully aware of the huge stress load the women at this site are carrying (including yourself, I might add), so give some thought about the effects when you decide to post "information."
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Avatar universal
There is obviously a small risk of seeding, we discussed at length with our oncologist from a major London teaching hospital. She reckoned risks were very small, so small they took almost no care during their procedures.......for the later lumpectomy pushing WGL wires right through the proven cancerous tumour as a matter of course....

I disagree with that carelessness, but what can one do? Do we all sue the NHS for negligence?

Surely the John Wayne study shows a 50% relative increase in risk. So say if 2% get metastases with lumpectomy, 3% get them after a messed up biopsy, but 97%, the vast majority have no problem...

I also read it with care, there seems to be a suggestion that it could be more the disturbance of the cancer itself, which starts an inflamation in the tumour that causes the problem by draining into the lymphatic system rather than seeding on the needle track. Maybe take an anti inflamatory with proven anti cancer power such as curcumin found in turmeric, = an Indian curry spice. We take it, it costs less than a £1 at Sainbury, best dissloved in something like scrambled egg or a veggie curry.  
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Avatar universal
Hi there....
unfortunately you asked me to give you this information!!!!!!!

And as for posting controversial information.....IT'S ON THE NET

freely accessed by all those women accessing this site.....

If we don't challenge these processes they will never change or be investigated...

It appears to be a great worry about metastasis through core biopsy......which is the question that I posed in the first place.....

Surgical hygiene is of highest importance....ie...the careful removal of tumor and areas that it may touch....a little like the childrens game...OPERATION....being careful not to touch the  piece of tissue to anything else on extraction....this we have no control over except to search for a surgeon that you feel you can trust....all of which can be stressful....we can use this site to ensure that we all know our rights and our choices.....there is one thing that is hard..the fact that we don't have the perfect answer.....I have discovered much in the last couple of weeks...I do have rights and even in the UK we have choice (new to us)
Any woman searching on the web and looking on this site will have looked everywhere else....and read all the facts and figures already.....
The National Health Service sites are far more scary than any question posed by me, I will not quote from it....as it is distressing, and unnecessary, and it does not challenge, but merely tells you how bad things can be..NICE!
Please don't ask for links then grumble when you get them....research yourself it is sooo easy, we have all looked at those sites anyway.
We should be standing together and saying....If it was a man's testicles that were squashed flat on cold metal plates, after you have been made to  sit with those same testicles hanging down under a hair washing gown in the open waiting room....scared of crossing your legs in case your bits drop out, then being recalled for a large core biopsy straight into your testicles, again being made to wear nothing down below in the waiting room than a Velcro fixed miniature cape.......then told to wait for 2 weeks until your results come through......things would be different!!!!
So lets grumble and make a stand to change things, get screening for all, and research and money spent on alternatives to invasive biopsies to isolate cancer patients, lets research core biopsies and metastasis, and lets share information, because together we would have PATIENT POWER
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Avatar universal
No, you posted the seeding info out of context and with no link. I merely asked you to provide the link so that the now freaked out women could go read the entire thing in context.
One of the things the veterans of cancer and biopsies will tell you is that researching every scary possibility while you are waiting for biopsy results isn't necessarily a good thing, as it raises anxiety levels way up. Being basically informed is one thing, but focusing on all the worst case scenarios when already extremely stressed is just asking for a meltdown. There is time for research after the waiting is over.
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Avatar universal
Here in England we call that closing the gate after the horse has bolted...

not much good in researching AFTER you are trying to achieve the best results for yourself
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