A lump or mass developed in the breast may be cancerous or benign. A biopsy of the lump confirms if the mass is benign or cancerous.
Breast biopsies are performed on over a million women in the United States each year. About 20 percent of these biopsies result in a breast cancer diagnosis. Most women who receive a breast biopsy do not have breast cancer. Approximately four out of every five breast biopsies are cancer-free.
What is a breast biopsy?
A breast biopsy is a diagnostic technique in which a tiny piece of breast tissue is removed for examination under a microscope by a specialist. If the tissue sample reveals cancer, the physician can have it further evaluated to offer the most precise diagnosis. It is an important first step to providing patients with the best therapy for their specific kind of breast cancer.
A breast biopsy is performed when:
- Mammography or other breast imaging (such as an ultrasound) indicates an abnormality
- You feel a lump in your breast
- A physician observes anything worrisome (such as dimpling or a change in skin texture) during a clinical evaluation that warrants further investigation
2 main types of breast biopsies
- Surgical biopsy
- Core-needle biopsy
The type of breast biopsy recommended by the doctor may be determined by the appearance of the concerned region, as well as the size and location of the tumor in the breast.
Following the biopsy, a pathologist examines tissue for changes under a microscope. The pathology report determines whether cancer exists.
A surgical biopsy is often performed under local anesthesia or after intravenous administration of drugs that make you drowsy.
The surgeon makes a one to a two-inch incision in the breast and extracts some or all of the suspicious tissue along with some healthy surrounding tissue.
If a lump is seen in mammography or ultrasound but is not felt, a radiologist may implant a small wire to mark the site for biopsy.
Core needle biopsy
A local anesthetic is used to perform a core-needle biopsy. A hollow needle is inserted into the breast by the doctor, and a little quantity of suspicious tissue is removed. A small marker may be implanted within the breast by the doctor. It denotes the location of the biopsy.
Core-needle biopsies are often performed by radiologists or surgeons utilizing specialized imaging equipment.
- Ultrasound-guided core-needle biopsy: Ultrasound imaging is used to guide the needle to the suspicious area. The doctor will extract some tissue using the needle, and the needle is safely removed. This technique will need you to lie on your back or side.
- Stereotactic-guided core-needle biopsy: To guide the needle in a stereotactic-guided core-needle biopsy, X-ray equipment, and a computer are used. Typically, you lie on your stomach on a specific table for this type of biopsy. The biopsy will be done via an opening in the procedure table.
- Freehand core-needle biopsy: There is no ultrasound or X-ray equipment used in a freehand core-needle biopsy. It is used less frequently and exclusively for lumps that are palpable through the skin.
How accurate are breast biopsies?
Surgical biopsies and core-needle biopsies are both effective methods to detect breast cancer. However, biopsies are not always correct. Breast cancer can be missed by a biopsy in a few situations.
The accuracy of surgical biopsies and ultrasound or stereotactic-guided core-needle biopsies is essentially the same. Core-needle biopsies performed by hand are less precise.
A biopsy might result in bleeding, bruising, and infection. Core-needle biopsies are substantially less likely to cause severe complications than surgical biopsies.
Risks of breast needle biopsy
The patients will experience discomfort, bleeding, or infection, which are typically short-lived. Discuss them with your doctor before treatment.
Some people are concerned that a breast needle biopsy could spread the malignancy. However, there are no indications of harmful long-term consequences from a breast needle biopsy. The advantages of a breast needle biopsy over a surgical biopsy or no biopsy at all outweigh the hazards.
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What is breast cancer?
Breast cancer is cancer in which abnormal cells of the breast proliferate uncontrollably. There are several types of breast cancer. The kind of cancer is determined by which cells in the breast develop into cancer.
Breast cancer can develop in a variety of locations within the breast. A breast is composed of three major components:
- Lobules: Glands that generate milk.
- Ducts: Tubes that transport milk to the nipple.
- Connective tissue: Fibrous and fatty tissue surround and bind everything together.
Most breast cancers start in the ducts or lobules.
Breast cancer can spread outside of the breast via blood and lymph arteries. Cancer is considered to have metastasized when it spreads to other regions of the body.
2 most common types of breast cancer
- Invasive ductal carcinoma: Cancer cells start in the ducts and subsequently spread to other regions of the breast tissue. Invasive cancer cells can metastasize.
- Invasive lobular carcinoma: Cancer cells develop in the lobules and subsequently move to nearby breast tissues. These invasive cancer cells have the potential to spread to other places in the body.
Other less common types of breast cancer include:
- Paget’s disease
- Medullary breast cancer
- Mucinous breast cancer
- Inflammatory breast cancer
Ductal carcinoma in situ is a kind of breast cancer that can progress to invasive breast cancer. These cancer cells are limited to the duct lining and have not spread to other tissues in the breast.
Health Solutions From Our Sponsors
Agency for Healthcare Research and Quality. Core-Needle Biopsy for Breast Abnormalities. https://effectivehealthcare.ahrq.gov/products/breast-biopsy-update/clinician
Gruen D, Pass H. Breast Biopsies: Everything You Need to Know. Stamford Health. https://www.stamfordhealth.org/healthflash-blog/womens-health/breast-biopsy/
Centers for Disease Control and Prevention. Breast Cancer. https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm
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- One in every eight women in the United States develops breast cancer.
- There are many types of breast cancer that differ in their capability of spreading (metastasize) to other body tissues.
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- inverted nipple,
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- a change in the size or shape of the breast or nipple.
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