A breast biopsy is a diagnostic procedure to identify the presence of cancerous cells in the breast tissue conclusively. It is the test used by the doctor to confirm breast cancer in women. Women who have lumps on their breasts need to see their doctor immediately. If tests like mammograms find abnormal lesions, then the doctor suggests for the diagnostic test. Based on the test results, the doctor suggests a treatment plan to eliminate or manage the disease.
About Breast Biopsy
A breast biopsy is a procedure to remove tissue or fluid sample from the suspicious area of the breast. The technician tests the sample in a lab under a microscope to detect malignant cells. It is the only procedure to determine definitively if the suspicious lesion in the breast is cancerous or not. Women who undergo never have to worry because in the majority of the cases, the results may indicate no malignant cells. So, it is a diagnostic procedure to conclusively determine the cause of unusual breast changes or concerning/suspicious findings on the mammogram or ultrasound. The diagnostic test helps your doctor decide on further treatment or additional surgery.
You have different types of biopsy procedures. Each procedure involves extracting the sample tissue from the suspicious area of your breast. Some techniques using imaging tests like ultrasound or MRI to get the sample. The final aim of each procedure is to get adequate samples to detect a cancerous presence.
Importance Of Breast Biopsy
The best method to deal with cancer is to catch it at the earliest stage. Detecting cancer early improves your chances of eliminating the problem. So, you can get effective treatment to improve the quantity and quality of your life. When you suspect any abnormalities, you need to see a doctor. The doctor suggests imaging tests to screen the problem. If various screening methods show changes or lumps indicating cancerous tissue, then your doctor suggests a biopsy. So, your doctor can recommend the procedure during the following circumstances:
- You or your doctor detect a lump or abnormal thickening in the breast indicating the cancerous presence
- The mammogram shows a suspicious lesion or area in your breast
- An ultrasound scan shows suspicious finding
- The breast MRI reveals abnormal finding
- You see changes in your breast like a nipple or areolar changes (it can include blood discharge, dimpling skin, scaling or crusting)
Risks Associated With Breast Biopsy
When you undergo any of the biopsy procedure to extract the sample tissue, it is not free of risks. You need to talk to your doctor in detail about the issues associated with the procedure. The most common risks associated with the procedure include:
- Swelling and bruising of the breast
- Bleeding or infection at the biopsy site
- Depending on the tissue removed and wound healing the breast appearance changes
- Need for additional surgery or other treatment option, depending on the biopsy result.
Women who undergo the procedure need to see a doctor if they develop an infection. The signs associated with infection are:
- Develop fever
- Biopsy site becomes red
- Warmth at the biopsy site
- Developing an infection at the biopsy site is a serious complication. So, it needs prompt medical attention.
Preparing For Breast Biopsy
Before undergoing the procedure, you need to talk to your doctor in detail. You have to cover the following issues with your doctor:
Before Breast Biopsy
- Inform your doctor about any allergies you suffer (medication or others)
- Convey the list of medications you take like anticoagulants (blood-thinning medications)
- If you have taken aspirin in the last few days
- Have taken aspirin in the last seven days
- If you are unable to lie face down (on your stomach) for an extended period
- Women who have a pacemaker or other electronic devices implanted in their bodies need to inform it beforehand. It is especially important when you undergo a procedure using MRI (Magnetic Resonance Imaging). Women who are pregnant or trying to get pregnant need to inform the doctor before MRI as it can harm the unborn baby.
After Breast Biopsy
You need to wear a bra for the appointment. It helps place the cold pack against the biopsy site after the procedure. As the bra holds it in place, you can feel relief from pain and discomfort. It also offers support to your breast.
What To Expect During Breast Biopsy
The doctors use different breast biopsy procedures to extract the sample tissue from the breast. Your doctor recommends a specific procedure based on the following:
- Size of the tumor
- Location of the tumor
- Different characteristics of breast abnormality
You need to talk to your doctor about the different types and why the specific type suits you. The doctor can offer a clear explanation. Before the procedure, the doctor gives an injection at the biopsy site to numb it. You can expect the following with the different types of biopsies:
Types Of Breast Biopsy Procedures
The different procedures for extracting breast tissue samples from affected women are:
Fine-Needle Aspiration Biopsy
It is the simplest type of biopsy used to extract breast tissue. The doctors also use the procedure to evaluate a lump detected by the doctor during the clinical breast examination. While undergoing the procedure, you need to lie on the table. The doctor steadies the lump with one hand and uses the other to insert a thin needle into the lump. Your doctor collects the sample of fluid or cells from the lump using the needle attached to the syringe. Tested the contents of the syringe reveals or rules out cancer. The procedure offers a quick method to check the difference between a solid mass and fluid-filled cysts.
It is ideal when patients cannot undergo a more invasive procedure. The doctor can obtain a good sample when the mass is solid. The pathologist tests the tissue sample to detect the presence of malignant cells.
Core Needle Biopsy
The doctors use the specific procedure to assess the lump in the breast detected during an ultrasound or mammogram. It is also suggested when the doctor feels during a clinical breast examination. During the procedure, a radiologist or surgeon uses a hollow, thin needle to extract a tissue sample from the mass, developed in your breast. The doctor uses ultrasound images to extract the sample tissue. With ultrasound guidance, the doctor collects several samples. Each sample the size of a rice grain gets analyzed to detect the different features that point towards breast cancer. Apart from ultrasound, the doctor can use other imaging techniques like mammogram or MRI to guide the positioning of the needle to get the sample tissue.
The type of biopsy procedure uses imaging technology like mammograms to detect the exact location of the suspicious lesion. So, it can pinpoint the areas within the breast that contains abnormal breast tissue. When you undergo the procedure, you need to position yourself in such a way that it makes it easier to access the area of testing. Therefore, you can lie face down on a biopsy table or seated in a particular position. The technicians help position the breast that needs testing in a hole of the special padded biopsy table. You have to remain in the position for at least thirty minutes or more. After positioning the equipment under the table, your doctor raises the table. The doctor raises the table to several feet based on the necessity.
Your doctor takes mammogram films called SCOUT films. Your doctor takes it by firmly compressing the breast between two plates. The mammogram images show the exact area of the breast from where the doctor needs to extract the sample. After using a local anesthetic, the radiologist makes a small opening or incision about six millimeters (1/4 inches long). The incision on the breast aids in removing the sample tissue using a vacuum-powered probe or a needle. Computerized pictures help in confirming the exact placement of the needle or probe for tissue extraction. The sample tissue gets tested in the lab for the presence of abnormality.
Ultrasound-Guided Core Needle Biopsy
This type of biopsy needs an ultrasound to get the sample correctly. The core needle biopsy uses the imaging method for identifying the exact position of the abnormal lesion. Ultrasound imaging is a sophisticated technique that produces clear images of the internal structures using high-frequency sound waves. The patient undergoing the procedure needs to lay back or on the side of the table. During the procedure, the radiologist holds the transducer (ultrasound device) against the breast. It helps to see the structures within the breast and locate the mass. After finding the mass, a small incision can help insert the needle to extract the sample tissue. The radiologist takes severe core samples for testing. Ultrasound imaging also offers clear images that can differentiate solid lesions and cysts.
MRI-Guided Core Needle Biopsy
As the name suggests, MRI guidance is required to perform the biopsy. Magnetic Resonance Imaging technique captures the internal structures in your body using a strong magnetic field. It provides several cross-sectional images of the breast. Your doctor combines all the images using a computer to generate a detailed image. The 3-D image offers an idea to the radiologist on the location of the lesion or lump. During the procedure, the patient needs to lie on the stomach on a padded table. The special table has a hollow depression on it where the breast will fit. The MRI machine generates images needed to detect the exact location for performing a biopsy. After finding the location, the doctor makes a small incision of six millimeters to insert the core needle. Then, your doctor extracts several samples of the tissue for testing and analysis.
The above-mentioned procedures use a tiny clip or stainless steel marker. It is placed on the breast at the suspected location. The marker on the biopsy site is useful when the results reveal cancerous or precancerous cells in the tissue. So, the doctor can locate the cancerous tissue using the marker and remove the tissue surgically. The process is known as a surgical biopsy. Read ahead to know more about the surgical biopsy.
During the procedure, the doctor removes a portion of the breast mass or an entire mass. The procedure to remove a part is known as an incisional biopsy. While the removal of the entire mass is referred to as wide local incision, lumpectomy or excisional biopsy. The surgical biopsy is the procedure performed in the operation theater after giving sedation to the patient. Your doctor gives you sedation through the vein in your hand or arm (intravenously). The area of the incision is numbed before the procedure using a local anesthetic.
If your doctor cannot feel the lump in your breast, then a technique called wire localization can help detect the area. It can guide the radiologist to the lump in the breast. Before performing the surgery, your doctor positions the tip of a thin wire within the lump in the breast or through it. It can detect the exact location of the lump.
During the breast biopsy surgery, the surgeon tries to remove the entire lump along with the wire. The sample is tested in the lab. It is to check if the entire mass in the breast is removed during the procedure. The pathologist first checks for cancerous presence in the lump extracted during the procedure. If breast cancer (presence of malignant cells) is detected, then the pathologist evaluates the margins or edges of the sample. It is to check for the presence of positive margins (cancerous cells in the margins). The detection of positive margins means you need another surgery. It is to remove more tissues. A clear or negative margin indicates the cancer is removed during the procedure.
Recovering From Breast Biopsy Procedure
In spite of the different types of procedures, the recovering process is more or less the same. You have to follow the guidelines suggested by the doctor. Here are the tips you have to strictly abide to ensure a complete recovery from the procedure:
You need to take it easy after the procedure. So, take the rest of the day off. You can resume your normal activities the day after the procedure.
Pace Ice Pack
Except for surgical biopsy, other procedures have bandages. You need to place an ice pack over the biopsy site to reduce the discomfort. It also reduces the swelling caused by the procedure.
Wear Special Bra
You need to wear a special bra for some days after the procedure. It is to keep the dressing over the biopsy site in place. The special bra can also hole the ice pack in place and offer comfort.
Never Remove Incisions/Taping Yourself
Stitches or small strips of tape can remain over the incision site. But, never remove it by yourself as it can harm you. You need to see the doctor for a follow-up appointment to remove the stitches or wait until the stitches fall off by themselves.
Bruising is common after any biopsy procedure. So, you can see the area becoming black or blue after a few days. It remains to have the same color for some days. It is nothing serious and a normal occurrence.
Medication For Pain Relief
After the biopsy, you can experience pain and discomfort for some days. Your doctor can either suggest prescription pain relief medications or the over-the-counter pain reliever offer relief from pain. It is always better to take a non-aspirin pain reliever containing acetaminophen. Aspirin based medication can increase your risk of bleeding. So, avoid the use of such medication for the first three days after the procedure. Talk to your doctor before taking or continuing any medication when recovering from the procedure.
Your doctor provides you with the guidelines you need to follow while recovering. So, you need to follow the suggested steps religiously. Therefore, you have to take care of the following:
- Apply medication as suggested by the doctor to the biopsy area.
- Ensure you change the bandages for faster wound healing and prevent infection.
- Follow the suggestion provided by the doctor on showering or bathing.
- Complete the wound care instruction as suggested by the doctor.
Results Of Breast Biopsy
You receive the results if a breast biopsy at your doctor’s office. People have to wait for several days to receive the results. After the procedure, the doctor sends the sample breast tissue extracted for testing in a lab. A pathologist (the doctor specialized in testing the blood and body tissue) examines the sample. It is observed under the microscope and analyzed using special procedures. Based on the findings, the pathologist prepares a report. Your doctor receives the result from the pathologist and informs you.
Contents Of Breast Biopsy Result
What does the result contain? The biopsy results are usually shared with your doctor. It contains the details included by the pathologist about the tissue sample. The information includes the size and consistency of the sample. The report also includes the location of the biopsy site. Your sample tissue may or may not contain cancerous cells. So, the report explains in detail the presence of malignant, non-malignant or precancerous cells present in the tissue.
Interpreting Breast Biopsy Result
The biopsy result can inform you about the findings of the sample tissue sent to the lab. How is it interpreted? Here are the results explained in detail:
With normal results, the pathologist and the radiologist may have the same opinion. So, the tissues show no signs of malignancy.
If your breast biopsy reveals normal results or benign breast changes, your doctor will need to see if the radiologist and pathologist agree with the findings.
Benign Breast Changes
In the case of benign breast changes, the doctor check for the opinions of the radiologist and pathologist. Sometimes the opinions may differ. The radiologist may feel the mammogram results indicates the presence of suspicious lesions like precancerous lesion or malignant lesion. But, pathologist finds normal cells in the sample breast tissue. In such cases, your doctor suggests surgery to extract more tissue for a detailed evaluation of the area.
Presence Of Breast Cancer
If the report indicates the presence of malignant cells, then your doctor will discuss the extent of the disease. It includes the stage and the type of cancer you suffer. The report also consists of additional information like if the cancer is hormone receptor-negative or positive. Based on the results, you and your doctor can develop a proper treatment plan meeting your needs.
A breast biopsy is the only procedure to determine the cancerous presence in the breast when a physical examination or mammogram indicates an unusual lump. Breast cancer is one of the common causes of death in women. With early diagnosis, it is possible to eliminate cancerous cells. A biopsy is effective in determining the problem and developing a treatment plan to handle the problem. The different biopsy procedures can help with early diagnosis. Talk to your doctor about the procedure to overrule any suspicions and improve the quality of life with prompt medical care.
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