A breast biopsy is a surgical procedure in which the doctor will remove and get a breast growth sample from the affected breast. The breast sample removed will then be subjected for examination for confirmation of the presence of cancer cells. The breast tissue sample is extracted by a needle or excision with a surgical blade during a surgical procedure. The sample will be sent to the laboratory for examination and evaluation by the use of a microscope. This is usually performed by a pathologist to confirm if there is non-cancerous or the so-called benign growth or cancerous or the so-called malignant growth.
Picture 1 – Breast Biopsy Procedure
The abnormal growth can be referred to as lump, mass, lesion, and tumor.
Breast Biopsy Procedure & Types
Picture 2 – Breast Biopsy types
Stereotactic Breast Biopsy
A stereotactic breast biopsy is a safe and less invasive kind of breast biopsy. It is indicated to get small samples from abnormal breast growth for laboratory examination. Biopsies are the only reliable method to prove if the problem is cancerous (malignant) or non-cancerous (benign).
A stereotactic breast biopsy is a substitute option if you do not want an open or surgical biopsy. A computer-guided imaging system will be used to help the surgeon locate the sample breast tissue. The breast tissue will be extracted using a needle. It will be performed on an outpatient basis with less discomfort and less recovery time.
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Most of the time stereotactic breast biopsy is a safe procedure. Although in rare cases bruises or infection in the site of biopsy may occur. If any of these risks occur, they are usually manageable with proper treatment. There are also cases that one biopsy will not be enough because a larger tissue is required to remove therefore another biopsy is performed.
While stereotactic breast biopsies are usually enough to find the nature of a breast mass, at times a larger piece of tissue may need to be removed. In that case, another biopsy may be needed. After the procedure, the removed sample is sent into the laboratory to be examined by a pathologist. The results are usually available after two to four days.
MRI Guided Breast Biopsy
An MRI-guided breast biopsy is very helpful for patients because it costs less, can be done in less than an hour, and has little risks compared to open surgery. This is usually done if the areas involved can be seen under MRI.
The breast sample once found under the MRI can be removed either by needle or vacuum device. Local anesthesia is required for the procedure and the needle or vacuum device can leave little or no scar.
Excisional Breast Biopsy
An excisional breast biopsy is a surgical procedure wherein the surgeon makes a cut in the skin and removes a sample or the entire abnormal mass for laboratory examination. Excisional breast biopsy will leave a noticeable scar on the breast and at times will result in an alteration of the breast shape. It is recommended if you first talk to your doctor about the size of the cut and about the scar and the breast changes that might happen after the biopsy. After a few days after the biopsy, expect to have mild pain and swelling in the surgical site for several days. The result will usually take three to four days to become available.
Picture 3 – Breast Biopsy Procedure
Breast Biopsy Results
Immediately after the surgical procedure, the breast tissue sample will be sent to the laboratory. A pathologist, a doctor who is specialized in looking at cells to confirm diseases, will study the sample to look for malignancy or cancer.
If the result is negative or benign, the interpretation is no cancer was present. If you are having doubts about the negative result you can ask for a second opinion wherein another pathology doctor will look at your breast sample. Once you are sure that the result is really negative it is still recommended to have mammograms regularly and to see your doctor for regular breast examinations. It is also important to always do a self-breast examination and know the changes in your breasts that are abnormal and always report abnormal changes in your doctor right away. Always remember to discuss the risks of breast cancer and if you have them with your doctor.
It is important to do both mammograms and physical examinations. A mammogram may show abnormal growths or changes that can’t be detected during a physical examination. On the other hand, a physical examination may detect a lump or skin change that a mammogram can’t be detected. If you happen to see any breast changes when you are having a breast self-exam call your doctor immediately. It is important to know that breast changes do not necessarily mean breast cancer.
If the result is positive or it detects breast cancer, the positive results will tell your physician vital information on the cancer state. First, it would tell if the cancer is in situ or invasive. If the cancer is in situ it means that cancer began inside a milk gland or duct, a tube that transmits milk from milk gland to nipple, and has not expanded to the adjacent breast tissue or to other organs. If the cancer is invasive or infiltrating cancer it means that the abnormal growth began in a lobule or a duct and has expanded to the adjacent breast tissues. Invasive type may expand cancer to the other organs of the body when it spread to the lymph nodes. Once it spread inside the lymph nodes the cancer cells will spread in the lymph system and into the bloodstream.
Second, the result of the biopsy will also show the speed of the cancer cells. The pathologist will look into the arrangement of the cancer cells to find cancer’s grade. The cancer grade will signify how fast or how slow the cancer is probably to divide and expand. Also, they can use other measures like Ki-67 tests which show how fast the cancer cells will spread and will help doctors to figure out what treatment is more suitable for you. The pathologist can also see if the cancer is HER2-positive. When the cancer is classified as HER2-positive it is more likely to grow faster compared to other types of breast cancers. The HER2 test is only done on newly diagnosed breast cancer patients and they can be managed by drugs that fight the HER2 protein.
Third, the result of the biopsy will show you if cancer will respond to hormone therapy. Some breast cancers have estrogen and progesterone receptors. If they have these receptors it means that they respond to estrogen and progesterone so hormone therapy will likely be beneficial.