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 other health-care professionals perform 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 breast symptoms should I be concerned about?
- What should the patient tell the doctor about the growth?
- How does a physician confirm the presence of a breast growth?
- Is anesthesia needed for a breast biopsy?
- What about pain and complications from a breast biopsy?
- What are the advantages and disadvantages of nonsurgical 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
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. The doctor simply feels (palpates) the suspicious area to the needle to the site. 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. Atypical cells found in a fine-needle aspiration biopsy may signal that cancer is present or that repeat biopsies are necessary.
- 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.
How is a core needle biopsy (CNB) done?
A core needle biopsy (CNB) can also be done in several different ways:
- Core needle biopsy (CNB) for palpable growths: This procedure is similar to FNAB for palpable growths except that that the needle used has a wider diameter and is equipped with a cutter that removes cores of tissue up to a ½ inch long. A key advantage of this procedure is that the samples are larger than in FNAB and thus enhance the possibility of making an accurate laboratory analysis.
- Guided CNB for non-palpable growths: This procedure also uses a wide needle with a cutter that removes cores of tissue large enough to enhance the accuracy of laboratory analysis. However, because the growth is deep in the breast or otherwise not palpable, stereotactic imaging, ultrasound, or MRI is used to locate the growth.
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