About Breast Biopsies

Most breast conditions are benign (noncancerous), causing no serious harm to you. But all women are at some risk for breast cancer and this risk increases as they become older.

Many thousands of women have breast abnormalities that may cause some concern. These lumps can be smaller than a pea or as large as an orange. There may be one lump or many lumps. They can be solid or filled with fluid (cysts). Some are benign, and others are likely to be cancerous; a few of them are in between. Some lumps can be felt, whereas some are seen only on mammography. Some abnormalities in the breast are as small as grains of sand. These are referred to as microcalcifications. Because not all lumps are the same, they do not all need to have a sample taken of them (biopsy) in the same way.

Diagnosis

The majority (75%) of these breast lumps are not cancerous. In a woman whose mammogram indicates a risk of cancer of less than 2%, it is usually reasonable that she be observed carefully by her physician and have another mammogram in 4 months. Generally, if the risk of cancer is thought to be greater than 2%, removing some of the suspicious tissue for testing (a biopsy) is recommended. The biopsy can be done in several ways: fine-needle aspiration biopsy, needle core biopsy, open biopsy.

Dr. Reyes and the staff at Gleneagles Surgery will help you understand the surgical options available to you and help you decide on the best and most effective treatment plan for you.


Biopsies

Fine-Needle Aspiration Biopsy

In fine-needle aspiration biopsies, the skin of the breast over the suspicious area is swabbed with an antiseptic solution. A fine needle is then used to inject an anesthetic into the skin to make the area numb. Using x-ray or ultrasound as a guide, a fine needle is placed through the numbed skin and down into the suspicious mass and some cells are removed.

Needle Core Biopsy

Sometimes, a large needle is used so that several cores (that are about as thick as the lea in a pencil) of the suspicious are are removed. In both instances ( fine-needle aspiration biopsy and needle core biopsy), the specimens are sent to the pathology department for examination.

Open Biopsy

Generally, if the risk of the mass being a cancer is substantially higher than 2%, removal of the entire lump by operation is advised.

Axillary Sentinel Node Biopsy

In a sentinel lymph node biopsy, a radioactive substance and/or a dye is injected near the tumor site. Then, the first lymph nodes that pick up the dye (called the sentinel lymph nodes) are removed and reviewed by a pathologist to check for the presence of cancer cells. This procedure is sometimes preferred to standard lymph node dissection because it involves removing fewer lymph nodes.

A sentinel lymph node biopsy is commonly used in breast cancer treatment. Since it helps to spare lymph nodes in the underarm area, this procedure may help to prevent a condition known as lymphedema, in which excess fluid collects in tissue and causes swelling.