A breast biopsy is a procedure for collecting tissue samples that are analyzed for cancer and other forms of medical abnormality. Analysis takes place later, in a lab. Physicians typically perform biopsies when there is a possible indication of cancer resulting from a mammogram, ultrasound, or magnetic resonance imaging (MRI) exam. There are several different methods for conducting biopsies. It’s important to note that biopsies are a diagnostic rather than a corrective tool, and that many biopsies return negative results (that is, they find no evidence for cancer or disease).
Biopsies are a critical weapon in the medical war on cancer. Be sure to schedule a regular breast exam with the experts in women’s health at Baptist Health.
When Are Breast Biopsies Performed?
Examination results than can trigger a biopsy include:
- The presence of a lump or unusually dense tissue in the breast
- Indications of lesions in a mammogram
- Indications of lesions in an ultrasound scan
- Evidence of microcalcifications or other suspicious areas in an MRI scan
- Bloody or unusual nipple secretions
- Nipple inversion
- Crusting or dimpling on the surface of the breast.
It is estimated that one case of breast cancer is detected for every five to ten biopsies that are performed.
What Types of Breast Biopsy Are There?
Breast biopsies vary in method. Your physician will select one based on the size, location, and suspected nature of the tissue to be sampled.
Biopsies typically involve some form of anesthesia. For a non-surgical biopsy, you will be injected with a local anesthetic to mask the pain. Surgical biopsies require a general anesthetic, which will put you to sleep.
There are several common methods for conducting a breast biopsy:
Fine-needle Aspiration Breast Biopsy
The most basic form of breast biopsy is fine-needle aspiration. It is sometimes performed during routine breast exams if a lump is discovered. Your physician will insert a needle into the lump, withdrawing fluid and cells for testing.
Fine-needle aspiration is an effective method for differentiating between a cancerous mass and a fluid-filled cyst. The latter is rarely harmful, the former, more so. The discovery of a cancerous mass may necessitate additional tissue collection and analysis.
Core-needle Breast Biopsy
Core-needle biopsies utilize a larger needle for sample collection. Tissue samples in the shape of tiny cylinders are extracted for laboratory analysis.
A related technology is called vacuum-assisted core biopsy. Sample tissue is removed with a spinning knife inserted into the breast by means of a hollow tube. The tube creates a vacuum that pulls small amounts of tissue into contact with the knife.
Stereotactic Breast Biopsy
A stereotactic breast biopsy combines tissue collection with the use of a mammogram to guide extractive technology to the lesion or abnormality being tested. You lie face down on a surgical table with a hole for positioning the breast. This enables the radiologist to perform the mammogram prior to tissue removal. Once the lesion has been located, a needle or tube will be inserted to collect the sample.
Stereotactic biopsies can also be conducted in a seated position. The procedure typically takes from 30 minutes to an hour to complete.
Ultrasound-guided Breast Biopsy
An ultrasound-guided breast biopsy is another variation on the core-needle approach. Here an ultrasound scan is produced by a transducer placed on the breast by the radiologist. On locating the suspicious mass, he or she inserts a needle to extract a sample.
A similar procedure can be performed with MRI technology.
Surgical Breast Biopsy
Surgical biopsies are more invasive than other forms. They take place in an operating room, with the patient fully sedated. The procedure requires both a radiologist and a surgeon.
There are two major types of surgical biopsy: incisional and excisional. Incisional biopsies remove part of the lump for laboratory analysis, while excisional biopsies remove the entire lump. An excisional biopsy is also called a lumpectomy.
Recovering from a Breast Biopsy
Breast biopsies usually result in a quick recovery. You should be able to resume normal activities in a day or two. The insertion site of a non-surgical procedure will require bandages and ice to control swelling. If you had a surgical procedure, you’ll have stitches to care for. Take a non-aspirin pain medication to manage discomfort. If you experience any bleeding or infection, contact your physician immediately.
Breast Biopsy Results
The samples collected during a biopsy are forwarded to a medical lab. There a specialist in diseases, called a pathologist, will analyze the tissue for evidence of cancer. If no cancer cells are found, the lump is considered benign. If cancer cells are detected, then the lump may be malignant. Your physician will use this information to determine the next steps in a course of treatment.
Surgical biopsies provide additional information about the cancer, assuming evidence for the disease is found. The pathologist will look for signs that the cancer is metastasizing or spreading. Future treatments will depend on the nature and disposition of the cancer cells.