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Breast Biopsy:

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Breast Biopsy: What to Expect When a Lump Is Detected What Is A Biopsy? A biopsy is a procedure that removes a sample of cells or tissue from the breast to be examined. – PowerPoint PPT presentation

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Title: Breast Biopsy:


1
Breast Biopsy
  • What to Expect When a Lump Is Detected

2
What 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.

3
When 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.

4
Visiting 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.

5
Types 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.

6
Needle 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

7
Needle 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.

8
Advantages of Needle Biopsies
  • Simple procedure does not require surgery
  • Accurate
  • Quick only takes a few minutes
  • Not painful
  • Inexpensive
  • Quick results

9
Disadvantages 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

10
Open 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

11
Incisional 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

12
Excisional 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

13
Advantages 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

14
Disadvantages 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

15
Imaging 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

16
Summary
17
Important Information to Know...
18
Why 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.

19
How 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.

20
Will 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.

21
How much does a biopsy normally cost?
  • Biopsies range in price depending upon the
    technique.

22
If 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?

23
Is 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.

24
What 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.

25
How 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.

26
Advanced 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.

27
What 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.

28
What 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.

29
Mammotone 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.

30
Advantages 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.
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