Eligibility was assessed and consent obtained. The treating oncologist completed a questionnaire, before obtaining a biopsy from a metastatic lesion, to determine their treatment plan and the proposed start date. Once biopsy results were available, oncologists were again surveyed to determine whether their treatment plan had changed based on the biopsy results and to determine the actual start date of treatment. Procedural success rate was assessed as the number of matched histopathologic examinations of primary and metastasis as a proportion of biopsies undertaken. Delay of therapy was evaluated as the duration between the proposed and actual treatment start dates. Patient satisfaction was assessed using questionnaires, which were administered to all consenting women at the time of clinic follow-up; these evaluated adverse effects resulting from the biopsy procedure and willingness to recommend metastatic biopsy to other women