In a new study from Sweden's Karolinska Institutet, researchers present a novel technology to reduce the risk of tumor spread and bleeding associated with fine-needle biopsy in suspected cancer. The technology is called Anti-Seeding, and has been clinically tested in breast cancer on a small scale at St. Görans Hospital in Stockholm during a one year period. The researchers will now move forward with larger studies in other cancers, and are also working to develop the technology to enable treatment of some cancers in parallel with the needle diagnostic procedure.
Most deaths in cancer are due to metastases, which spread from the primary tumor to other organs in the body. It has been suspected for a long time that living cancer cells may detach from the primary tumor already during tissue sampling, and grow as daughter tumors in other parts of the body. However, it is still unclear to what extent this is a real risk. The new needle technology, presented in an article in the British Journal of Cancer, prevents possible spread of detached cells directly when the tissue sample is taken. This is made possible by converting the needle movements made by the operator to an electric signal that is fed to a computer that automatically transforms the movements of the needle into heat pulses within the tissue. The heat is obtained by friction from radio frequent electric current in the needle, according to a similar principle as in a microwave oven.
In their study, Professors Hans Wiksell and Gert Auer and colleagues first examined the blood droplets coming out through the needle track during fine-needle biopsies in 88 breast cancer patients. They found that the blood in as many as 74 % of the cases contained living cancer cells. Another 31 patients were then examined with the help of the new combined diagnostic-treatment needle technology. When the collected blood droplets from the patients were studied, the researchers found that the living cancer cells had disappeared completely. The bleeding caused by the biopsy also decreased. The researchers could also proof that the tumor sample quality was not deteriorated by the new technology, and that the patients didn't seem to feel more pain than from an ordinary fine-needle biopsy.
The plan is now to proceed with randomized trials in several cancers, including lung cancer and liver cancer where the risk of tumor spread is greater than in breast cancer. The Anti-Seeding technology should also be adapted for core-needle biopsies, which is most common when taking diagnostic tissue samples. Further trials are also underway with a much larger version of the Anti-Seeding technology (PRFA), where the so-called Minimally Invasive Surgery is performed early on small breast tumors. This treatment can then be done with local anesthesia only and requires no access to special operating room facilities.
In addition to the researchers at Karolinska Institutet and St. Görans Hospital, researchers at the Karolinska University Hospital and Sabbatsbergs Hospital in the Stockholm area have participated in the study. The work was funded by AFA Insurance, VINNOVA and NeoDynamics AB, the latter a company that Hans Wiksell has started and now runs.
- H Wiksell, K-U Schässburger, M Janicijevic, K Leifland, L Löfgren, S Rotstein, P-O Sandberg, C Wadström, G Auer. Prevention of tumour cell dissemination in diagnostic needle procedures. British Journal of Cancer, 2010; DOI: 10.1038/sj.bjc.6605964
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