Breast Cancer: Biopsies

Biopsies

A biopsy is done when other tests show you may have breast cancer and the only way to see for sure is by performing a biopsy. During this test cells are removed from the breast and studies in a lab. There are several types of biopsies including: fine-needle aspiration, core needle, and biopsy lab tests.

Fine-needle aspiration biopsy (FNAB)

In this test, a very thin (fine) needle is used to draw fluids out of the lump. Your physician may use ultrasound to guide the needle into the lump. The fluid may be clear, bloody, and in some cases there may be small pieces of tissue removed and looked at under a microscope. If this does not provide a clear answer, you may need more testing and this will be discussed with you by your physician.

Core Needle Biopsy

A needle is guided by an x-ray (sterotactic) or by ultrasound to remove pieces of the tissue (core) for examination by a pathologist. A local anesthetic is used to number the area so that a small opening can be made in the skin to allow the biopsy needle to enter the breast. The radiologist inserts the needle to take a piece of the tissue and at times may place a small clip at the site to mark where the tissue was removed. After the procedure, steri-strips (tape) are placed with a pressure dressing and ice.

Stereotactic breast biopsy systems

Mammography alone cannot determine whether suspicious tissues are benign or malignant; often, patients must undergo surgical biopsy - a time-consuming, uncomfortable and sometimes disfiguring procedure. Because many biopsies indicate benign (non-cancerous) growths, the Allegheny Cancer Center offers stereotactic biopsy technology as an equally effective, yet less traumatic, approach.

Using the digital stereotactic X-ray guided probe - rather than a knife - this system takes less than half the time of a traditional biopsy and requires only a local anesthetic. Patients usually return to normal activity soon after the procedure. Patients, when indicated, can undergo stereotactic biopsy on the same day or within a few days to establish a diagnosis.

Mammotome Breast Biopsy

Patients with imaging findings that suggest cancer first undergo a unique biopsy technique - the Mammotome Breast Biopsy System - to enable physicians to obtain the correct amount of breast tissue for a definitive diagnosis. In some patients, chemotherapy is given before surgery to decrease the size of the tumor. Once the tumor has decreased in size, doctors are able to remove a smaller amount of tissue from the breast.
For patients with breast cancer who are receiving preoperative chemotherapy to decrease tumor mass, a small, stainless steel marking clip adds a new dimension to the fight against the disease. By marking the precise location of the tumor bed (area of origin), the clip may help preserve breast tissue.
Because the tumor may shrink significantly during the five to eight months of chemotherapy, it is sometimes difficult to determine where the original tumor began. In these cases, patients may be referred for clip placement to mark the tumor site which allows localization of where the tumor originated to more conservatively remove the cancerous tissue. This enables women to undergo breast-conservation surgery as opposed t a mastectomy.

The Mammotome biopsy procedure - which requires only local anesthetic and can be performed on an outpatient basis - was created to sample tiny abnormalities called micro- calcifications (which can be the earliest or only indication of cancer), making early detection faster, easier and more precise.
The radiologist places the Mammotome probe within the abnormal area of the breast, using stereotactic (X-rays from two different angles) or ultrasound guidance. A vacuum system gently draws tissue into a sample chamber. A rotating device cuts the small tissue sample and sends it to a tissue collection area. The stainless steel clip may be inserted through the Mammotome needle and placed as a "marker" on the breast tissue requiring only a single insertion.

The Mammotome system has been shown to be as accurate as traditional open surgical biopsy in diagnosing certain breast cancers and three times more accurate than a core needle biopsy in diagnosing conditions associated with early-stage breast cancer.

 

Last Updated: May 30, 2008