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What is a Breast Biopsy?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 10 November 2016
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It is perhaps one of the most frightening scenarios to women. They find a lump, have other potential indicators of breast cancer, or a mammogram comes back showing unusual tissue in the breast. In most cases, doctors will recommend a breast biopsy to either rule out or rule in presence of cancer. As scary as this recommendation can be, the biopsy itself, which collects some of the tissue in question, is a good thing, and may frequently show that no cancer exists. Knowing the different kinds of biopsies can also help make this procedure slightly less frightening.

The more aggressive form of the breast biopsy is surgical removal of suspect tissue, which usually takes place under at minimum twilight sleep, a type of sedation that causes profound sleepiness. Sometimes general anesthesia is used instead. Depending on the location of the lump, a surgeon will have to make a small to large incision to get to the lump, and the incision is stitched when the tissue removal is complete. These biopsies may remove all abnormal tissue or only a small amount. This matter may be discussed beforehand between a surgeon and patient, or it might be up to the discretion of the physician to decide how much to remove once the lump is viewed.

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Not all types of the breast biopsy are the same. The two least involved kinds are usually fine-needle aspiration and core needle breast biopsy. In fine-needle aspiration, a thin needle is injected into the breast where a lump is present, and a small amount of tissue or fluid is removed. Since many lumps turn out to be non-cancerous cysts, this method is very often preferred, especially in patients who are at extremely low risk for breast cancer. Core needle breast biopsy might be thought of as a step up, where the needle is slightly thicker and can remove matter from a lump. This procedure may be guided by a variety of machines that help create an accurate pathway for the doctor.

Depending on what machines might be used with the core needle breast tissue removal, this type of breast biopsy might take place in a few different ways. Some women need to lie on a table on their stomachs while the breast is biopsied by a surgeon or doctor below them. This occurs in stereotactic core needle breast biopsy, which uses mammograms to guide removal of tissue, and in MRI (magnetic resonance imaging) guided core needle biopsies. In sonogram or ultrasound imaging, women typically lie on their back. Any one of the core needle biopsies may require small incisions in the breast to access the lump.

In all types of breast biopsy, removal is only Part A. The second part is laboratory analysis to determine if cells, fluid or tissue found is cancerous. Tests tend to be completed in no more than a few days, though a woman should consult her doctor about when she can expect to hear results. As previously stated, many biopsies return normal results, but it also fair to state that some certainly do not. However, identification of cancer, especially early, can make a huge difference in treatment, and is the principal reason why women are asked to do monthly self-exams that could lead to a biopsy if a lump is found.

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