A breast biopsy usually is performed to determine if an abnormal area or lump in your breast is cancerous. In this procedure, a tissue sample of the area of concern is removed so it can be examined by a pathologist . Breast biopsy may involve one of three main techniques: fine needle aspiration , biopsy core needle , biopsy or surgical biopsy .
Your doctor will choose the technique that best fits your situation. During a fine needle aspiration biopsy, your doctor will insert a needle into your breast, some form of guidance such as an ultrasound probe will be used to guide the needle to the correct area, then fluid or a small sample of tissue will be removed.
A core needle biopsy is done to remove several small pieces of tissue or cores of tissue from the breast. It may be guided using one of several techniques during a stereotactic core needle biopsy. You will lie facedown on a table with your breasts inserted through a hole in the table. Your doctor will inject a local anaesthetic to numb the area then using a digital mammogram as a guide. Your doctor will insert a hollow needle into the area of concern. Several small cylinders of tissue will be removed for examination.
During an ultrasound guided core needle biopsy, your doctor will use an ultrasound probe to locate the area of concern. A hollow needle will be inserted to remove several cores of tissue fine needle aspiration and core needle biopsies involve removing small samples of fluid or tissue using a needle. However, if an area of concern detected by mammogram or ultrasound is not accessible by a core needle biopsy, or if your physician wants to remove the entire area, a surgical biopsy may be recommended.
A surgical biopsy is done in an operating room using two techniques: excisional biopsy and incisional biopsy . During excisional biopsy, your surgeon will make an incision in the breast and remove the entire mass at the end of the procedure, the incision will be closed.
Your surgeon will perform an incisional biopsy if only a small part of the area of concern needs to be removed, usually to make a diagnosis . At the end of the procedure, the incision will be closed. If the abnormality cannot be felt, needle localization will be used to mark the location of the area of concern. During this procedure, your radiologist will insert a hook wire into the breast through a needle under mammogram or ultrasound guidance in order to mark the area the needle will be removed, but the wire will stay in place . You will then go to the operating room where your surgeon will make an incision in the breast. He or she will follow the wire to locate the targeted area , then remove it. An x-ray will be taken of your breast to make sure the targeted area has been removed, then your surgeon will close the incision.
A fine needle aspiration is chosen when the lump is likely to be filled with fluid . If the lump is easily accessible or if the doctor suspects that it may be a fluid-filled cystic lump, the doctor may choose to conduct a fine-needle aspiration (FNA).
Core needle biopsy is the procedure to remove a small amount of suspicious tissue from the breast with a larger “core” (meaning “hollow”) needle. It is usually performed while the patient is under local anesthesia , meaning the breast is numbed.