What Is the Difference Between Fine-Needle Aspiration and Stereotactic Biopsy?

Medically Reviewed on 1/25/2022
breast stereotactic core biopsy/fine needle aspiration
Fine-needle aspiration is a similar procedure to a stereotactic biopsy; however, they both differ in the following ways.

A tissue sample from the breast can be obtained using one of several breast biopsies. Based on the size, location, and other characteristics of the suspicious area in the breast, the doctor may recommend a specific procedure. Often, biopsies will begin with an injection to numb the area of the breast that will be biopsied.

The differences between a needle aspiration and stereotactic biopsy include:

Fine-needle aspiration biopsy

  • This is the most basic type of breast biopsy, and it can be used to evaluate a lump felt during a clinical breast exam.
  • The patient lies on a table for the procedure.
  • While holding the lump steady with one hand, the doctor inserts a very thin needle into it with the other hand. The needle is connected to a syringe, which can extract cells or fluid from the lump.
  • A fluid-filled cyst and solid mass can be distinguished quickly using fine-needle aspiration.
  • Fine-needle aspiration may aid in the avoidance of a more invasive biopsy procedure. However, if the mass is solid, the patient may require a procedure to collect a tissue sample.

Stereotactic biopsy

  • Mammograms are used in this type of biopsy to pinpoint the location of suspicious areas within the breast.
  • The patient will typically lie face down on a padded biopsy table with one of their breasts positioned for this procedure.
  • During mammograms, the breast is tightly compressed between two plates to show the radiologist the precise location of the area for a biopsy.
  • The radiologist makes a small incision in the breast about 0.25-inch long (about six millimeters).
  • They then insert a needle or vacuum-powered probe into the tissue and remove several samples.

Biopsies involve the removal of tissue samples that are then sent to a lab for testing.

When other tests reveal something in the area that needs to be investigated further, a biopsy may be required. If a lump is discovered during the biopsy, it may be removed at the same time.

Lymph nodes in the surrounding area should be examined. Biopsy results will be reviewed by the doctor, and treatment options will be suggested.

Do I need a breast ultrasound after mammogram?

If a person has dense breast tissue, a doctor is more likely to recommend an ultrasound after a mammogram. Dense breast tissue is neither abnormal nor dangerous. However, cancer cells may be hidden in the dense tissue.

Diagnostic radiologists can use an ultrasound to distinguish cancer cells in dense breast tissue that would otherwise be undetectable with a mammogram. Dense tissue increases the risk of breast cancer and makes mammogram results more difficult to interpret.

  • A mammogram uses standard X-ray technology. Fatty tissue appears grey, whereas dense tissue appears white. A cancerous tumor would be white.
  • An ultrasound works by using sound waves that bounce off tissue. Different tissues produce very different echo patterns, which can be used to detect cancer cells or tissue.
  • A mammogram provides them with a complete picture of the breast, including the location of the dense tissue. An ultrasound focuses on the dense tissue and reveals what's inside.
  • Even though a needle biopsy is still the only way to test for cancer, if there is a suspicious mass within regular dense tissue, an ultrasound can detect it.

Regular mammograms can aid in the early detection of breast cancer.

  • A mammogram is a screening test that detects breast cancer when it is a one-quarter inch or smaller in size.
  • Mammograms allow for the early detection of some precancerous conditions and early-stage cancer that appears on mammography as tiny calcifications (microcalcifications) but are not detectable by physical examination.

Mammograms are classified into two types:

  1. Screening mammogram: In cases where there is no known problem, it is usually performed one time a year as part of a routine preventive health checkup.
  2. Diagnostic mammogram: It is performed when there is a known problem that necessitates careful examination. It provides much more detailed images than screening mammograms including views from different angles and compression, or blow-up, views. If there is a palpable lump, an ultrasound may be performed in addition to the mammogram.

When a lump is discovered, a screening ultrasound and biopsy are performed to determine whether the lump is cancerous or aggressive.

QUESTION

A lump in the breast is almost always cancer. See Answer

Can a man be diagnosed with breast cancer?

Although breast cancer in men is uncommon, they should be aware of risk factors and treatment options. Breast cancer is a malignant tumor that develops from breast cells. 

Before puberty, both boys and girls have a small amount of breast tissue and a few ducts (tiny tubes that carry milk) located beneath the nipple and areola. Girls’ breasts grow as a result of hormonal changes during puberty. Male breast tissue does not grow as much as female breast tissue after puberty.

  • Male breast tissue has ducts and may have a few lobules (glands that produce milk if the right hormones are present).
  • Men's breast duct cells, like any other cell in the body, can develop cancer.
  • Because men's breast ducts are less developed than women's, this disease affects fewer men than women.

The cause of male breast cancer is unknown. However, there are risk factors that increase the likelihood of breast cancer in men:

  • The majority of breast lumps in men are caused by gynecomastia (enlargement of the breast caused by a hormonal imbalance)
  • Radiation exposure
  • High estrogenic levels caused by factors such as heavy drinking, cirrhosis, obesity, and some prostate cancer treatments may occasionally cause hormonal imbalance leading to breast cancer
  • Heredity, such as a breast cancer family history, a mutated BRCA1 or BRCA2 gene, and certain genetic disorders such as Klinefelter syndrome (presence of an extra X chromosome in men)
  • Men are more likely than women to be diagnosed with breast cancer between the ages of 60 and 70 years

6 treatment options for breast cancer

The type of treatment required by a patient with cancer is primarily determined by the type and stage of cancer. However, in most cases, patients are referred to a combination of treatments to achieve the best results.

The following medical treatments may be required by a patient with breast cancer:

  1. Surgery: The main goal of breast cancer surgery is to remove the cancerous tumor from the breast. If the cancer cells spread to the lymph nodes, the doctor may remove the lymph nodes in the underarm area (auxiliary nodes).
    • Depending on the circumstance, surgeons will recommend one of two types of surgeries:
      • Lumpectomy: Only the breast tumor and a small strip of normal tissue around it are removed. The remaining portion of the breast is undamaged. This is also referred to as breast-conserving surgery.
      • Mastectomy: The surgeon recommends removing the entire breast during a mastectomy (this includes the nipple and areola). With a few exceptions, this is true in the vast majority of cases.
  2. Chemotherapy:
    • This treatment aims to destroy cancer cells by injecting drugs directly into the veins with a needle or by taking pills. In some cases, a combination of both can be used.
    • Chemotherapy is frequently prescribed in conjunction with other treatments such as surgery, radiation, or hormone therapy.
    • It is an effective therapy that improves the chances of a cure, lowers the risk of relapse, alleviates symptoms, and contributes to the patient's overall quality of life.
  3. Hormonal therapy:
    • Hormonal therapy is used to block the hormones that promote the growth of cancerous cells.
    • The therapy is only recommended when breast cancer is found to have receptors for naturally occurring hormones.
    • It is frequently a post-surgery recommendation intended to reduce the risk of relapse. This treatment is used to shrink a tumor before surgery to ensure the best possible outcome.
  4. Biological therapy:
    • The immune system of the body is used in this treatment to target and destroy cancer cells.
    • The therapy stimulates the immune system, causing it to recognize and kill cancer cells.
    • It may be used to control tumor growth and prevent the spread of cancerous cells.
  5. Radiation therapy:
    • Radiation therapy for breast cancer kills cancer cells by using high-energy X-rays and other particles.
    • The treatment is extremely effective on cancer cells that are rapidly growing and susceptible to the effects of radiation therapy.
    • The primary goal of radiation therapy is to eliminate any remaining cancerous cells in or around the breast or lymph nodes after surgery.
  6. Other complementary medications:
    • Aside from the standard breast cancer treatments mentioned above, there are certain prescribed medicines and health practices that, when incorporated into daily life, can go a long way toward improving the patient's health.
    • Meditation and yoga, as well as vitamins and herbs, are frequently healthy ways to counteract any health-damaging effects.
    • These, however, do not replace conventional medicines.

With so many cancer treatment options available, patients may struggle to select the best one. A cancer specialist is the best person to explain the benefits and drawbacks of each treatment.

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Medically Reviewed on 1/25/2022
References
Image Source: iStock Images

Advanced Breast Cancer Diagnostics: https://www.nyp.org/brooklyn/womens-health/genetic-testing-and-counseling-program/stereotactic-biopsy-and-fine-needle-aspiration

Breast Stereotactic Core Biopsy/Fine Needle Aspiration: https://emedicine.medscape.com/article/1845123-overview

Breast cancer in men: https://breastcancernow.org/information-support/have-i-got-breast-cancer/breast-cancer-in-men

Breast Cancer: https://www.webmd.com/breast-cancer/understanding-breast-cancer-basics

How Is Breast Cancer Treated? https://www.cdc.gov/cancer/breast/basic_info/treatment.htm