Does a biopsy cause cancer to spread?

I went for a check-up and a small lump was discovered on my neck. I'm waiting for the biopsy results to determine if it's benign or malignant. Currently, my neck is painful and slightly swollen. Could a biopsy cause the cancer to spread? (Hoang Ha, Long An )

Reply:

Thyroid biopsy is a technique that involves taking a sample of thyroid cells using a fine needle for cytological testing, which helps determine whether a tumor is benign or malignant. Based on this, doctors can develop an appropriate treatment plan for the patient.

Thyroid cases that are commonly indicated for biopsy include thyroid nodules with TIRADS levels 4, 5, and sometimes TIRADS 3 (if the patient is overly concerned about the nodule). Biopsies may also be performed during surgery to obtain tissue for histopathological examination, helping doctors diagnose benign or malignant tumors and assess lymph node metastasis.

There are two types of biopsies: fine needle aspiration cytology (FNAC) and core needle biopsy.

Fine-needle aspiration biopsy is a common and minimally invasive procedure. A doctor uses a small needle to probe a tumor or lymph node in the neck, guided by ultrasound. The collected cell sample is then sent to a pathology laboratory. If fine-needle aspiration biopsy is inconclusive, the Head and Neck Unit doctor will recommend a core needle biopsy.

With core needle biopsy (less commonly used in thyroid surgery due to higher risks), doctors use a larger needle to obtain a cell sample. Taking more tissue provides the pathologist with more data for testing, leading to more accurate results compared to fine-needle aspiration.

Before a biopsy, whether it's a fine-needle aspiration or core needle biopsy, the doctor will reassess the thyroid nodule using ultrasound. The biopsy itself takes about 15-30 minutes, and the patient does not require anesthesia. After the biopsy, the patient may experience bruising and swelling in the neck area. These conditions resolve within a few days.

Thyroid biopsy does not cause thyroid cancer to spread, unless the diagnosis and evaluation process incorrectly identifies the malignant nature of the tumor, leading to delayed treatment. The cancer remains within the thyroid gland, leading to invasion and metastasis to the lymph nodes, lungs, brain, etc.

Without proper infection control, biopsies can also cause infection. Bacteria on the skin can enter the body through the biopsy needle, although this is rare. In addition, bleeding may occur. Some patients with blood clotting disorders or those taking anticoagulants should be carefully advised before undergoing a biopsy.

Inexperienced doctors performing biopsies may damage the tissues surrounding the thyroid gland. Nowadays, highly skilled doctors, combined with modern ultrasound equipment, can minimize such damage.

If the swelling and pain in your neck lasts for more than a week without going away, you should see a doctor for a more thorough examination.

MSc. Dr. Doan Minh Trong
Head and Neck Unit, Tam Anh General Hospital, Ho Chi Minh City

Readers can ask questions about cancer here for doctors to answer.

Source link