Breast Biopsy (cont.)

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How is a vacuum-assisted breast biopsy done?

Vacuum-assisted breast biopsy uses a special instrument and imaging guidance to remove breast tissue samples  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.

How is an excision biopsy of the breast done?

An excision (surgical) biopsy can also be done in different ways:

  • Surgical biopsy of palpable growths (lumpectomy): This procedure removes part or all of a breast growth, or lump. The doctor makes an incision one or two inches (about 2.5 to 5 cm) across and removes the sample. If the lump is small and measures an inch (2.5 cm) or less across, the doctor usually removes the entire lump for testing. If the lump is large, the doctor usually removes only a portion of it for testing. If cancer is found, the rest of the lump can be removed at the time of the biopsy or at a later time.

The doctor closes the opening with sutures or clips which remain in place for about a week. Patients who receive general anesthesia rather than a local will require about an hour to recover from drowsiness after the surgery.

  • Surgical biopsy for non-palpable lumps: This procedure is similar to lumpectomy except that the growth is first located by mammography or other imaging studies and then "marked." The doctor inserts a needle that conveys a wire with a hook on the end into the breast, all the while using the image as a guide. After anchoring the hooked wire to the lump, the doctor withdraws the needle and performs the surgery. Another option is to inject a dye to mark the spot rather than using a hooked wire.
Medically Reviewed by a Doctor on 2/10/2014

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