Immediate clip migration after breast biopsy: a meta-analysis for potential risk factors

OBJECTIVES: Immediate clip migration following breast biopsy is not a rare condition but its impact on future cancer management can be profound. However, there is limited knowledge on what causes the phenomenon and how to prevent it. METHODS: A systematic search was performed to identify articles discussing factors associated with clip migration, and a meta-analysis for each risk factor was conducted to determine the risk ratio. RESULTS: The most significant risk factor for immediate clip migration is globally fatty breast (RR = 2.00 [1.43-2.80], P<0.00001), while local heterogeneity has a moderate but insignificant protective effect (RR=0.68 [0.45-1.04], P=0.07). Clips with bioabsorbable carriers and biopsy along the superior/inferior breast axis do not change the rate of clip migration. CONCLUSION: Intrinsic breast composition is the most important determinant for accurate clip placement. Further research to identify potentially modifiable factors, such as clip design and biopsy techniques, is needed. ADVANCES IN KNOWLEDGE: Fatty breast composition has the highest risk of clip migration. Research on potentially modifiable factors such as clip design and biopsy techniques is needed.