Title: Breast Biopsy:
1Breast Biopsy
- What to Expect When a Lump Is Detected
2What Is A Biopsy?
- A biopsy is a procedure that removes a sample of
cells or tissue from the breast to be examined. - The cells or tissue are then examined under a
microscope to look for signs of cancer. - Only 1 in 5 women who have biopsies will actually
be diagnosed with cancer.
3When a lump is found.
- When a lump is found, a biopsy is the first step
in diagnosis and treatment. - Although the primary purpose is to diagnose
cancer, a biopsy can also be a surgical treatment
to remove cancer.
4Visiting the Doctor
- After a lump has been detected, the doctor will
follow a step by step process. - First, the doctor should begin by asking about
your personal family history. - Next, the doctor may order follow-up tests, such
as diagnostic mammograms and ultrasound imaging,
which can provide additional information about
suspicious lumps. - However, to make a definite diagnosis of breast
cancer, a biopsy must be performed.
5Types of Biopsies
- There are two main types of biopsies
- Needle Open Biopsy
- Your options for biopsy are determined by
whether the lump is palpable (can be felt) or
non-palpable (can not be felted), the location of
the lump and the womans general health. -
6Needle Biopsy
- A needle biopsy is a procedure that uses a needle
to remove tissue or cells from the breast. - There are two types of needle biopsies
- Fine Needle and Core Needle Biopsy
7Needle Biopsies
- Fine Needle A thin, hollow needle is used to
remove a sample of tissue. The procedure is
quick and can be done in a doctors office. - Core Needle A larger needle is inserted through
a small incision in the skin, and a small core of
tissue is removed. This type of needle biopsy is
done with the assistance of mammography or
ultrasound imaging in a doctors office or
hospital outpatient clinic.
8Advantages of Needle Biopsies
- Simple procedure does not require surgery
- Accurate
- Quick only takes a few minutes
- Not painful
- Inexpensive
- Quick results
9Disadvantages of Needle Biopsies
- Entire lump is not removed
- Open biopsy may be necessary
- For Fine Needle Only
- Specialist needed to read results
- In situ cancer not distinguishable from invasive
cancer
10Open Biopsies
- An open biopsy is a surgical procedure that opens
the breast to remove tissue. - There are two types of open biopsies
- Incisional and Excisional
11Incisional Biopsy
- A surgical procedure where only a portion of a
tumor is removed - Generally reserved for lumps that are larger
- Performed under local anesthesia in a hospital or
outpatient clinic
12Excisional Biopsy
- A surgical procedure that removes the entire
suspected area plus some surrounding normal
tissue. - Standard procedure for lumps that are smaller
than an inch or so in diameter - Similar to a lumpectomy
- Performed under local anesthetic or general
anesthesia in a hospital or outpatient clinic
13Advantages of Open Biopsies
- Quick takes only one hour
- More accurate than a needle biopsy
- Larger samples provide information for treatment
plan - Excisional Only
- Removes entire lump
- May be the only surgical treatment needed
14Disadvantages of Open Biopsies
- Surgical procedure
- Expensive
- Side effects such as infection or blood
collection under the skin - Excisional Only
- Removing tissue can change the look and feel of
the breast
15Imaging Techniques
- When a lump cannot be felt, the doctor must
locate it with a special imaging technique. - The doctor may use mammography (sometimes called
stereotactic localization) or ultrasound imaging - The lump is located by mammography or ultrasound
- The doctor inserts a needle to collect a sample
of tissue
16Summary
17Important Information to Know...
18Why is it necessary to have a clinical breast
exam once you have found a lump?
- A doctor can tell a lot about a lump from its
size, texture, and the way it moves within the
breast. Sometimes an abnormal lump may be a
liquid-filled sac called a cyst. Doctors can
collapse these cysts by inserting a very thin
needle and drawing out the fluid.
19How long is the procedure for a needle biopsy?
- A fine needle aspiration only takes a few
minutes. A core needle biopsy takes under one
hour.
20Will an anesthetic be used during the biopsy?
- A local anesthetic is used in needle biopsies.
A person can have either a local anesthetic
and/or a sedating anesthesis in an open biopsy.
21How much does a biopsy normally cost?
- Biopsies range in price depending upon the
technique.
22If a mammogram or clinical breast exam reveals
something suspicious and your physician suggests
a biopsy, you may want to ask the following
questions
- What type of biopsy will I have?
- How reliable is this particular biopsy?
- Are there any effects of a biopsy?
- How long will the biopsy take?
- Can I eat or drink before the biopsy?
- Will the biopsy leave a scar?
- When will I be able to return to my normal
routine? - How soon will I know if I have cancer?
- If I do have cancer, what other tests will need
to be done?
23Is there anything that would affect the
diagnosis?
- Test results may not be accurate if the biopsy
sample does not contain enough tissue to make a
definite diagnosis.
24What happens if the biopsy results indicate
cancer?
- There are several things that may happen
-
- There may be follow-up tests to determine
treatment. Tests may be done to determine if the
tumor is dependent on hormones (such as
estrogen). These are called estrogen and
progesterone receptor tests. If the tumor is
dependent on hormones, treatment with a
medication such as tamoxifen may be advised. - 2. If the biopsy confirms cancer, follow-up
tests, including radiographic tests, blood
studies, and bone scans determine treatment.
25How long after diagnosis will treatment begin?
- If the biopsy confirms cancer, the doctor will
talk to you about treatment options. Treatment
for breast cancer usually begins within a couple
of weeks after the biopsy. This gives you time
to - Learn about treatment options and breast
reconstruction - Get another medical opinion
- Have tests that tell if the cancer has spread to
other parts of the body - Prepare yourself emotionally
- Make personal and work arrangements
- A short delay between the biopsy and treatment
will not reduce the chances that your treatment
will be successful.
26Advanced Breast Biopsy Instrumentation (ABBI)
- The ABBI procedure is performed under local
anesthesia and is a one-step biopsy procedure.
This means that it combines needle localization
with the removal of the lump. - Using stereotactic techniques, a technician
pinpoints the lump with the aid of the computer,
which calculates the precise location of the
lump. The area is numbed with a local anesthetic
and a marking needle is inserted to tag the
precise location. A narrow tube-like device is
inserted into the breast to obtain a specimen.
The small opening in the breast is closed with a
few stitches.
27What are the advantages of the ABBI procedure?
- The results are available in 24-48 hours.
- The ABBI procedure takes less than one hour.
- The ABBI procedure is minimally invasive,
therefore allowing the woman to experience less
time in healing and recovery. - The ABBI procedure may be an alternative to open
biopsies for non-palpable lesions. - The ABBI procedure is currently the only
procedure other than the traditional open surgery
method which has the capability to remove a lump
or a cluster of microcalcifications in their
entirety.
28What are the disadvantages of the ABBI procedure?
- A downside to the ABBI procedure is
availability. It is a relatively new technique
and many physicians may not be trained in the
procedure or have the available equipment.
29Mammotone Minimally Invasive Breast Biopsy
(MIBB)
- The Mammotone and MIBB are very similar and are
often called Large Core Needle Biopsies. - The Mammotone and MIBB are different from the
core needle biopsy in that a needle is inserted
once and multiple specimens are removed through
contiguous sampling. Core needle biopsies
require the needle to be inserted multiple times.
- Both the Mammotone and MIBB biopsy utilize a
vacuum system. A probe is inserted and samples of
tissue are collected in a chamber. Tissue
samples are removed by action of a gentle vacuum.
By rotating a thumbwheel, the physician moves
the sampling notch to the next desired position.
30Advantages of the Mammotone MIBB
- The sample of the lump is larger (up to 8X
larger), the needle is inserted only once to
obtain multiple samples, and the sampling is
contiguous and selective.