A breast biopsy is a procedure where by the doctor removes some or all the tissue for histological diagnosis. Histological diagnosis is performed by the pathologist (specialized doctor) who examines the tissues under a microscope to determine the exact cause of the abnormality.
It is natural to feel anxious when one is told that a biopsy is necessary, it is a procedure after-all. However, it is a minor procedure which can be done as a day case and occasionally can be performed in the clinic itself. Most patients who are asked to undergo biopsy do not have cancer.
So, if most patients do not have cancer, why the need for biopsy?
This is because a breast biopsy is part of triple assessment of breast lumps. Although most breast lumps are benign (not cancerous), some cancerous or pre-cancerous lesions can look benign on imaging. Hence, it is imperative to obtain tissue for diagnosis for confirmation.
What are the various types of biopsy?
There are many types of breast biopsy procedures. We will recommend the type that’s best for you based on certain factors, including:
The size of the suspicious area in your breast.
The location of the suspicious area in your breast.
How concerning the suspicious area looks.
Whether the mass is palpable during clinical examination
Your overall health and personal preferences.
The different types of breast biopsies, based on how the breast tissues is removed includes:
Fine-needle aspiration (FNA) biopsy: For this biopsy, a thin needle and syringe to draw out a sample of your breast cells or fluid. This biopsy is usually for breast lumps that are cystic (contains fluid) in nature.
Core needle biopsy: For this biopsy, a larger, hollow needle is used to remove one sample of your breast tissue per injection. This type of biopsy usually involves imaging guidance from ultrasound, mammography or an MRI.
Vacuum-assisted core biopsy: During this biopsy, a small incision is made in the skin to allow insertion of a special biopsy needle. This needle is attached to a vacuum-powered instrument to suction multiple, tiny samples of the breast tissue into the center of the biopsy needle. This method removes more tissue than a core biopsy performed with a regular needle and is usually performed with imaging guidance.
Excisional breast biopsy (lumpectomy): Surgery is performed to excise (remove) the entire lump or area of concern.
Incisional breast biopsy: Surgery is performed to remove only a part of the lump or the abnormal area.
The different types of breast biopsies usually requires imaging support to ensure that the area of concerned is removed, this is named accordingly to the type of imaging used, such as:
Stereotactic breast biopsy: During this breast biopsy, a mammogram is used to help find the area of your breast that need to be sampled.
Ultrasound-guided breast biopsy: During this breast biopsy, an ultrasound machine is used to guide the needle to the area that need to be biopsied.
MRI-guided breast biopsy: During this breast biopsy, an MRI (magnetic resonance imaging) machine is used to guide the needle to the area in your breast that need to be biopsied.
Is it safe?
As will all procedures, there are risks involved. However, the risks associated with breast biopsy are small. The possible side effects include bleeding and infection.
Can a breast biopsy cause cancer to spread?
No, a breast biopsy does not cause cancer cells to spread.
If we think it's a cancer, why can't we remove it? Why do we need this additional step?
Firstly, the breast biopsy helps confirm the diagnosis of cancer and can determine the subtype of breast cancer. The type of treatment required differs depending on the subtype of breast cancer. Although most patients with breast cancer will be advised to go for surgery first, some patients with certain subtypes (triple negative or HER 2 positive) will be advised to go for chemotherapy first.
Furthermore, the type of surgery for removal of cancer is not the same as that for excision biopsy. When a cancerous lump is removed during surgery, the aim is to remove a rim of normal tissue surrounding it to ensure complete removal. At the same time, some axillary (armpit) lymph nodes will need to be sampled to check if the cancer has spread beyond the breasts.
Book an appointment with us today to get your breasts checked!