title: Local breast cancer recurrence caused by mammographically guided punctures.
abstract: OBJECTIVE
  To evaluate the risk of needle track seeding or tumor cell implantation as the cause of locally recurrent breast cancer after breast conserving surgery.
  
  
  METHODS
  We reviewed recurrences from a consecutive series of 303 clinically nonpalpable breast cancers treated with breast conserving surgery after pre-operative localization. The median mammographic follow-up was 5.4 years. The suspicion of seeding or implantation was based on the location of the recurrent lesion in comparison with the needle path in two orthogonal mammographic projections. Pre-operative percutaneous biopsies had been done in 71% (214/303) of the cases. Postoperative radiotherapy was administered to 82% (194/238) of the invasive cancers and to 28% (18/65) of the ductal cancers in situ (DCIS).
  
  
  RESULTS
  Locally recurrent cancer occurred in 11% (33/303) of the cases. Radiotherapy demonstrated a protective effect from relapse among invasive cancers but not for DCIS. Seeding or implantation was suspected in 3 recurrent invasive cancers which had not been subject to radiotherapy. The histopathological diagnosis of the primary cancer and the recurrent cancer were the same in these cases: adenoid cystic, mucinous and tubuloductal cancer.
  
  
  CONCLUSIONS
  Seeding or implantation was suspected as the cause of local recurrence in 7% (3/44) of the invasive cancers which did not receive radiotherapy.
authors.affiliation: Department of Oncology, Radiology and Clinical Immunology, Uppsala University Hospital, Sweden.
authors.forename: M G
authors.initials: MG
authors.lastname: Thurfjell
authors.forename: T
authors.initials: T
authors.lastname: Jansson
authors.forename: H
authors.initials: H
authors.lastname: Nordgren
authors.forename: J
authors.initials: J
authors.lastname: Bergh
authors.forename: A
authors.initials: A
authors.lastname: Lindgren
authors.forename: E
authors.initials: E
authors.lastname: Thurfjell
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002278:Carcinoma in Situ / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000517:prevention & control; D009366:Neoplasm Seeding; D011677:Punctures / Q000009:adverse effects* / Q000295:instrumentation; D015641:Radiography, Interventional; D018714:Radiotherapy, Adjuvant