Breast Biopsy
 

 


What is a Breast Biopsy?

Dr. Lane reads mammogram

A breast biopsy is the removal of a small amount of tissue from the breast for evaluation under a microscope. Breast biopsies are used to determine if cysts and/or other abnormalities in the breast are cancerous or benign. They are a reliable way to diagnose problems.

There are a number of different types of non-surgical breast biopsy procedures. Non-surgical procedures are largely more popular than surgical procedures. The radiologists perform stereotactically guided mammotomy, needle localization and fine needle aspiration. These exams are done on an outpatient basis with a short post-biopsy recovery time. Generally, these types of breast biopsies are not painful, but may produce slight bruising and soreness.

More often than not, breast abnormalities turn out to be benign and require no further treatment.

Stereotactic Breast Biopsy / Stereotactically-guided Mammotomy:

This procedure uses a number of computerized mammogram images to identify a breast abnormality in 3-dimensions.

The procedure:

For this procedure, you will lie on your stomach on a specially made table. Your breast will be positioned through an opening in the table. The breast will be compressed moderately, similar to the compression occurring during a mammogram. A few mammographic images will be taken in order to properly position the probe which will remove the tissue.

When this is complete, the technologist will cleanse the area for biopsy. The radiologist then numbs the area with a local anesthetic. The probe will then be inserted into the breast, near the area of concern. The radiologist will rotate the probe slightly, gathering small cores of tissue. You will feel pressure around your breasts but no pain. Only a small nick in the skin will be left by the probe.

Sometimes it is necessary for the radiologist to retrieve some breast tissue that contains microcalcifications. Once the tissue is removed, this specimen is sent to be x-rayed. This xray film will confirm for the Pathology Department/Laboratory that the specimen contains the microcalcifications. After the retrieval of the tissue is complete, a tiny marker will be placed at the exact site from where the tissue was taken. This marker is left in should cancer be found, so that the surgeon will know exactly where to look to remove any remaining malignant tissue. If the abnormality is benign, as is the case in 70-80% of those examined, the marker will serve to show on future mammograms where the biopsy was done. The marker used cannot be felt and it will not set off any detector alarms.

The actual procedure takes about 10 to 15 minutes, although about an hour will be needed to allow for preparation time and instructions afterward. The procedure is about 97% to 99% accurate. There are no permanent scars left by the probe and no possibility of disfigurement.

Following the procedure:

When the biopsy is complete, steri-strips will be placed over the probe entry site. These will need to remain in place for about two days. During these two days, bathing is permitted as normal. A pressure dressing will be placed over the steri-strips followed by a snug support bra over the entire dressing. This must be kept on for 8 to 12 hours. All strenuous activities with the arms are restricted for 24 hours after the procedure to ensure proper healing. Most woman feel only minor discomfort in the days immediately following the biopsy, and most will have some bruising around the breast. This bruising and any marks left on the breast should be completely resolved in a few weeks.

You will be given post-biopsy instructions to take home as well as a contact number in case of emergency.

A radiologist will receive the pathology (lab) results and send a report to the physician who ordered your biopsy. This physician will review the results with you and decide on any additional procedures.

Surgical Excisional Biopsy with Needle Localization:

A radiologist will perform a needle localization with ultrasound or mammography guidance prior to surgery. A wire marker is placed inside the breast to guide the surgeon to the area of concern. This enables the surgeon to remove the least amount of tissue possible in order for a definitive diagnosis to be made.

The procedure:

For this procedure, a mammogram or breast ultrasound must be done before the localization wire can be inserted. Once the area of concern is located in the breast, the skin will be cleansed and numbed with a local anesthestic. The wire is then carefully inserted using the guidance of the mammography or ultrasound. Once the wire is in place, its position will be verified one more time by mammography. The wire is then left in place until the surgery. A soft dressing will be put over the wire and you will be transported to the operating room.

Following the procedure:

Following this procedure, the surgery will be performed. Surgery will, in itself, require stitches and post-operative care.

Fine Needle Aspiration:

Fine needle aspiration is a procedure which can be done in a physician's office, but it is performed more often by a radiologist in a medical imaging center. A fine needle aspiration is employed only when the abnormality is a palpable lump in the breast. This procedure calls for a very fine needle to be inserted into the abnormality to aspirate, or withdraw, some tissue cells.

The cells retrieved may help towards determining the diagnosis.

 

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