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Breast Biopsy

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Breast biopsy is a procedure used to test breast tissue for the presence of cancer. A small tissue sample is taken from the breast and evaluated for any abnormal cells that may indicate cancer.  This procedure takes about 45 to 60 minutes to be completed. There are different types of breast biopsies that are recommended based on the size and location of suspected tumor or cancer cells.

Reasons for Breast Biopsy

A breast biopsy is carried out in case of the following reasons:

  • Presence of lump in the breast that may be suspected as a cancerous lump
  • Changes in the size, shape, color or unusual discharge or bleeding of the nipple
  • Abnormal mammogram or breast ultrasound results

Types of Breast Biopsy

There are two major types of breast biopsies. These include surgical biopsy and core-needle biopsy. Both procedures have their own pros and cons. Let us  have a look at the various types of breast biopsy.

Surgical biopsy

Also called Open biopsy, this is a procedure where the breast is cut to remove a part or the entire lump present in the breast. There are two types of surgical biopsies:

Incisional Biopsy: A small cut is made in the breast to remove a small part of the suspicious lump or cells. These cells are then observed under the microscope for any abnormalities.

Excisional Biopsy: Removal of the entire mass or lump is called an excisional biopsy. Along with the abnormal mass, some normal tissues may also be removed.

The procedure is carried out under local anesthesia, wherein, the patient is awake and only the breast area is made numb. This surgery is more involved than core needle biopsy. One may be left with a scar as stitches are required to close the cut made. As some normal tissue is also removed, one may observe changes in size or shape of the breast.

Wire Localization is another process, where a thin, hollow needle with a wire in the center is inserted into the breast. This is usually carried out when the lump is deep seated and cannot be felt. With the help of the wire, the surgeon will locate the lump and carry out the biopsy.

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Core needle biopsy

A core needle biopsy is a procedure that is carried out with the help of fine needles. This procedure is carried out under local anesthesia.  The needle is inserted in the breast tissue about 3 to 6 times. This helps in getting many samples and give a clear result. The needle is guided into the abnormal tissue with the help of X-ray or ultrasound equipment. If the lump can be felt physically, then these imaging devices are not used. This procedure does not cause scarring , but can lead to bruising.

Core needle biopsy can be done with the help of different imaging assistance. Some of these include:

Vacuum-assisted core biopsy: This biopsy is carried out with the help  automated rotational core devices. A small cut is made on the breast and a hollow probe is placed in it. With the helps of X-ray, ultrasound, etc. the probe is guided into the tissue and the rotating knife in the probe cuts the sample tissues. Many samples are removed from the cut and the procedure does not cause any scarring.

Streotactic core needle biopsy:  In this procedure, X-ray and computer images are used to pinpoint the exact location of the abnormal tissue. The streotactic biopsy helps to biopsy microcalcifications in seen in the breast tissues.

Fine needle aspiration:

In this procedure a fine needle and a syringe is used to remove sample fluid from breast cyst as well as cells from a lump. The suspicious material from the breast is then analyzed for the presence of cancer. It takes a minute to perform and generally carried out without the use of anesthesia.

Before the Procedure

Before conducting the procedure the doctor will ask the patient to sign a consent form. This will be done after explaining the procedure and its pros and cons. One will be asked to avoid the use of creams, perfumes, deodorants, etc. on the breast as well as arms before the procedure. No other preparation such as fasting is required, especially if the procedure is carried out under general anesthesia.

The Actual Procedure

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The biopsy is carried out under local anesthesia. In some cases, general anesthesia can be recommended. The patient is given a gown to wear and lie down or sit on a chair. The skin will be thoroughly cleaned with the help of an antiseptic solution to prevent any infections. The local anesthetic injection will be given and the doctor will wait till the area becomes numb. With the help of X-ray or ultrasound the location of the lump or abnormal cells will be determined. A tiny incision is made or needle will be inserted depending on the procedure followed. The doctor will take samples of the tissues and sutures will be given in case of surgical biopsy. Also, during the surgical biopsy the patient may be given a sedative and made to sleep on an operating table. The tissue samples will be sent to the lab for further examination.

After the Procedure

The patient will be discharged after some time in case of local anesthesia given. If the patient was given general anesthesia, she will be kept in the recovery room for some time. Once the blood pressure, breathing and pulse are all normal, the patient will be discharged. If the area is bandaged, the doctor will instruct the patient about its removal. Sutures, if any, will be removed on next visit.

Breast Biopsy Risks

Some of the possible risks involved related to biopsy are as follows:

  • Bruising of the breast
  • Swelling in the breast
  • Slight bleeding at the site of infection
  • Change in breast size or shape due to removal of tissue

If one develops fever chills, redness, bleeding or pain around the site of biopsy, one should immediately contact the doctor.

Results

One may be quite apprehensive regarding the results of the breast biopsy. This is because the results may take quite a few days. Depending on size, consistency, color and other factors related to the sample the results may take a few days. If the test is normal or benign growth is found, the doctor may suggest its treatment. If the test is found to be cancerous, further tests may be carried out and a specific line of treatment may be suggested.

Breast biopsy does not always indicate the presence of cancer. It is a method of evaluation to determine if the suspicious lump, mass or cells in the breast are cancerous. Speak to your doctor in detail regarding the procedure and what to expect after the test is carried out.

Written by: Saptakee sengupta
Date last updated: February 27, 2015