Fifteen studies (n=5,369) were included in the review: three prospective studies and 12 retrospective studies. Median follow-up for four studies that reported the outcome of local recurrence rates ranged from 29.7 to 78 months.
Cells seeding/displacement (nine studies, n=927): Nine studies reported that malignant tumor cell displacement on surgical excision specimens was found in 22% of patients (range 2% to 63%).
Other outcome endpoints (six studies, n=4,442): Four studies reported that there was no significant difference in the local recurrence rate between patients who underwent a preoperative diagnostic needle biopsy and those who underwent an excisional biopsy. Local recurrence rates ranged from 1.1% to 3.7% for core needle biopsy group and from 2.1% to 10.3% for the excisional biopsy group. One study reported that the incidence of sentinel lymph node metastases was significantly higher in patients whose cancer was diagnosed by large-gauge needle core biopsy than those diagnosed using an excisional biopsy (OR 1.48, 95% CI 1.02 to 2.16). Another study reported that patients who underwent preoperative breast biopsy had a 1.37 times (95% CI 1.13 to 1.66) increased risk of sentinel node metastases. One study showed that there was a significant difference in the mortality rate between patients who underwent a preoperative biopsy and those who did not (0% versus 4.7%, p=0.002).
Risk factors associated with cell displacement were reported.