Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A core needle biopsy (CNB) can also be done in several different ways:
Core needle biopsy (CNB) for palpable growths: This procedure is similar to FNAB for palpable growths except that that the needle used has a wider diameter and is equipped with a cutter that removes cores of tissue up to a half-inch long. A key advantage of this procedure is that the samples are larger than in FNAB and thus enhance the possibility of making an accurate laboratory analysis.
Guided CNB for Non-Palpable Growths: This procedure also uses a
wide needle with a cutter that removes cores of tissue large enough to
enhance the accuracy of laboratory analysis. However, because the growth is
deep in the breast or otherwise not palpable, stereotactic imaging,
ultrasound, or MRI is used to locate the growth.
How is a vacuum-assisted breast biopsy done?
Vacuum-assisted breast biopsy uses a special instrument and imaging guidance to remove samples of breast tissue through a single, small skin incision. This technique allows the surgeon to remove more tissue through a single incision than is possible with a traditional core biopsy and is a much less invasive procedure than an open surgical biopsy.
The vacuum-assisted biopsy involves the placement of a biopsy probe using radiology imaging studies for guidance. Stereotactic mammography, ultrasound, and MRI have all been successfully used to identify the abnormal areas to be sampled by vacuum-assisted breast biopsy. Once the biopsy probe has been positioned, a vacuum pulls the breast tissue through an opening in the probe into the sampling chamber of the device. Then a rotating cutting device in the instrument removes the tissue sample, which is carried through the biopsy probe to a tissue collection receptacle.
The surgeon or radiologist then turns a control knob on the biopsy probe that moves the sampling chamber to a new position. This procedure is repeated until all desired areas have been sampled. In this way, samples can be taken all around a suspicious area through a single insertion of the biopsy probe. With a traditional core biopsy, sampling of multiple areas would involve repeated insertions of the biopsy instrument.
The vacuum-assisted biopsy technique is performed under local anesthesia and leaves a small incision that does not require stitches for closure. It takes less than an hour to perform, and patients can usually return to normal activities soon after the procedure.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Fibrocystic breast condition (sometimes called fibrocystic breast disease) is characterized by lumpiness and usually discomfort in one or both breasts. The condition is very common and benign (not malignant). Fibrocystic breast condition is the most common cause of "lumpy breasts" in women. A common symptom of fibrocystic breast condition is breast pain or discomfort. There are two types of fibrocystic breast condition, cysts and fibrosis, and Hyperplasia and atypical hyperplasia of breast cells.
Breast lumps in women can have a variety of causes such as breast inflammation, infection, injuries, cancer, and non-cancerous growths. Breast lumps in women are diagnosed with physical exam, mammogram, ultrasound, MRI, and biopsy. Treatment of breast lumps in women depend on the cause.
The breast generally refers to the chest, however, more specifically, to the mammary gland. The mammary gland is a milk producing gland comprised largely of fat. Within the mammary gland is a complex network of branching ducts. The ducts exit from sac-like structures called lobules, which can produce milk in females. The darkened area around the nipple is called the areola. Common medical concerns in regard to the breast include breast lumps, breast cysts, breast cancer, and breast infections.
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Inflammatory breast cancer is an accelerated form of breast cancer that is not usually detected by mammogram or ultrasound. Symptoms of inflammatory breast cancer include pain in the breast, skin change in the breast area, bruise on the breast,sudden swelling of the breast, nipple retraction or discharge, and swelling of the lymph nodes.
Lifestyle changes, a healthy antioxidant-rich diet, exercise, and weight reduction can help reduce a woman's risk of developing breast cancer. It's important to be aware of how risk factors such as family history, lifestyle factors, breast conditions, radiation therapy, and hormonal factors may influence your chances of developing breast cancer. Mammography and breast self-examinations are crucial steps in breast cancer prevention.
As breast cancer is the most diagnosed non-skin cancer in American women, it is important to know your breast cancer risk. Risk factors include age, age at menarche, age at first live birth, history of breast abnormalities, breast biopsies, race, and history or breast cancer among first-degree relatives.
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