Breast Biopsy (cont.)
Melissa Conrad Stöppler, MD
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.
William C. Shiel Jr., MD, FACP, FACR
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.
In this Article
- Breast biopsy facts
- What is a breast biopsy?
- What is the purpose of a breast biopsy?
- What specialties of physicians and practitioners do breast biopsies?
- Who should have a breast biopsy?
- In what setting is the breast biopsy done?
- What may a benign result indicate?
- How is a suspicious breast growth discovered?
- What should the patient tell the physician about the growth?
- How does a physician confirm the presence of a breast growth?
- Is anesthesia needed for a biopsy?
- What about pain and complications?
- What are the advantages and disadvantages of non-surgical procedures versus surgical breast biopsies?
- What are the different types of breast biopsy procedures and what do they involve?
- How is a fine needle aspiration biopsy (FNAB) done?
- How is a core needle biopsy (CNB) done?
- How is a vacuum-assisted breast biopsy done?
- How is an excision biopsy of the breast done?
- What is the time frame for receiving the results of a breast biopsy?
- Find a local Surgeon in your town
What about pain and complications?
Except for a minor sting from the injected anesthesia, patients usually feel no pain before or during a procedure. After a procedure, some patients may experience some soreness and pain. Usually, an over-the-counter drug is sufficient to alleviate the discomfort.
The risk of complications, such as infection and bleeding, is small for non-surgical procedures and slightly higher for surgical procedures.
What are the advantages and disadvantages of non-surgical procedures versus surgical breast biopsies?
Generally, non-surgical biopsies are less stressful, do not disfigure the skin, leave no internal scar to interfere with the accuracy of future mammograms, and minimize the risk of complications.
However, non-surgical biopsies are not always as reliable as surgical biopsies in producing a conclusive diagnosis. For this reason, some patients who undergo a non-surgical biopsy must also undergo a follow-up surgical biopsy.
What are the different types of breast biopsy procedures and what do they involve?
Breast biopsy procedures include:
- fine needle aspiration biopsy (FNAB),
- core needle biopsy (CNB),
- vacuum-assisted breast biopsy, and
- excision biopsy (surgery).
How is a fine needle aspiration biopsy (FNAB) done?
A fine needle aspiration biopsy (FNAB) can be done in several different ways:
- Fine needle aspiration biopsy (FNAB) for palpable growths: A palpable growth is one that can be felt. The patient usually sits up while the doctor inserts a small hollow needle with a syringe to withdraw (aspirate) fluid and cells from the growth for testing. To guide the needle to the site, the doctor simply feels (palpates) the suspicious area. When the needle reaches the mass, the doctor suctions out a sample with the syringe. The doctor repeats this procedure several times. If the mass is a cyst, the withdrawn samples will consist mainly of fluid and the cyst may collapse, relieving any pain the patient feels. If the mass is solid, the samples will consist primarily of tissue cells.
By analyzing the samples immediately after their withdrawal, a doctor may be able to determine that they came from a cyst and simply discard them, diagnosing the growth as benign. In all other cases, fluid and tissue samples are placed on slides and then analyzed by a pathologist in a laboratory.
- Guided FNAB for Non-Palpable Growths: When a growth is too small or deep to palpate (feel), the doctor must locate it with one of several imaging techniques. First, the patient lies face down on a table with the breasts suspended through an opening. With stereotactic mammography, mammograms of the suspicious breast site are taken from different angles to form a virtual three-dimensional (stereotactic) image that precisely pinpoints the location of the suspicious area. The computer then uses a motor to guide a small hollow needle to the site to remove the samples. The withdrawn samples are then analyzed for the presence of cancer. Ultrasound and MRI are other imaging techniques that may be used to guide breast biopsies.
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