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Biopsies of the Breast

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Biopsies of the Breast American Cancer Society After the procedure is complete, pressure will be applied to the needle site to help stop any bleeding and a bandage will be applied (usually an adhesive Guidelines strip). The procedure takes approximately 30 minutes. Regarding Breast Health Core Needle • Breast Self-Exam (BSE) – More recently the Your Results focus of BSE has been moving from the monthly Your specimens will be delivered to a pathologist who routine self-exam to becoming more self-aware Biopsy will examine them under a microscope. The findings of your breast changes and seeking help if any will be reported to your healthcare provider who will, in abnormalities are noticed. BSE represents a turn, forward the results on to you. structured way in which the breasts can be examined effectively. You should know how your Your Questions breasts normally feel and look. We realize this is a stressful time for you. As our patient, Beginning in their 20’s, women should learn the we want you to be as confident and informed about benefits of BSE. You can be instructed on the your healthcare as you can be. We hope this brochure proper techniques of BSE at the time of your has been informative for you. Please feel free to ask us routine health examination. You should also know any questions you may have. that there are limitations to BSE. Report any breast changes that you notice to your healthcare provider immediately. • Clinical Breast Exam – Women between the Risks ages of 20 and 30 should have a breast exam by a • There is a slight chance of developing bleeding healthcare provider every three years. Women age or an infection in the area of the biopsy. If an 40 and older should have a clinical exam annually. infection occurs, it can usually be treated easily with oral antibiotics. • Mammography – At age 40, women should begin to have annual mammograms. They may be • Core needle biopsy may leave a very small recommended at an earlier age if there is a strong round scar where the tiny incision was made family history of breast cancer or other risk factors. in the skin. For women at high-risk, the guidelines advise you A Woman’s Guide to discuss your risk with your healthcare provider to to Educated Breast Health Disadvantages decide whether or not additional testing is indicated. • Because a needle biopsy collects tissue from such a small area, there is a chance that a cancerous growth may be missed. • At times, the location of the lump may affect the accuracy of a core needle biopsy. If the lesion is deep within a small breast, very close to the nipple or next to the chest wall, it may be difficult to obtain an adequate sample. 640 Ulukahiki St-Kailua, HI 96734 Breast Health Navigator – (808) 263-5434 Scheduling – (808) 263-5166 © 2011 Customized Communications, Inc., 1.800.476.2253 All Rights Reserved with a 30-minute procedure. The procedure itself Core Needle involves local anesthetic, avoids disfiguring the breast How to Prepare and leaves no scar. It has almost no risk of infection You may eat a light meal prior to the procedure unless Biopsy and leaves you well enough to immediately return to your physician directs you otherwise. A comfortable normal activities. For this reason, many times women two-piece garment should be worn. You should not Your healthcare provider has identified a need for will prefer needle biopsy to the surgical option. wear powder, deodorant, lotion or perfume under your further testing of your breast. It could be the result of arms or on your breasts on the day of the procedure. an exam in which a mass was found, a mammogram A core needle biopsy is a procedure that involves If you take blood thinners or aspirin, you should talk to or a breast sonogram. A breast biopsy is the removal removing small samples of breast tissue using a hollow your physician about whether you should discontinue of a sample of the breast tissue in question in order “core” needle. The examination of those samples under using them prior to core needle biopsy. Any jewelry worn to examine it under a microscope. This will help a microscope can detect the presence of cancer cells. (earrings or necklaces) should be easily removable. determine whether the tissue is cancerous (malignant) Each sample taken is about the size of a pencil lead. or noncancerous (benign). Once it is established that When a lump is palpable (able to be felt), the lump What to a biopsy is needed, there may be choices in the type Expect is stabilized with one hand of the physician while the Upon arrival for your biopsy, you will be asked to sign a of biopsy. The types of biopsy include fine needle biopsy is performed with the other. If the suspicious consent form stating that you understand the procedure aspiration, stereotactic biopsy, excisional (open) area cannot be felt, ultrasound may be used. being performed and the risks involved and that you agree biopsy and core needle biopsy. to have the procedure. Talk to your healthcare professional Understanding the structures of the breast may be Biopsy Needle about any concerns or questions you may have regarding helpful for you. Below is a diagram of the normal the need for the biopsy, its risks involved or how it will be breast. An area that is questionable and needs further performed. It is important for you to feel comfortable with investigation may be in any part of the breast. your decision. Sample A core needle biopsy is most often minimally traumatic Tissue You will be escorted to a specially-equipped procedure and less expensive than a surgical or excisional biopsy. room and asked to undress above the waist. A paper or As the number of screening mammograms increases, Area of cloth drape or covering will be available for you to place the number of biopsies also increases. This biopsy Concern around your shoulders. The biopsy will be done while technique has spared many women unnecessary you sit or lie on an exam table. Your hands will be placed surgical procedures in the hospital setting as this at your side or above your head, depending on which particular procedure is done in the physician’s office. position makes it easiest to find the lump. An injection of When a core needle biopsy rules out cancer – and local anesthetic, with a very small needle, will be given most do – the patient has achieved that diagnosis to numb the area of the breast where the biopsy needle will be inserted. Once the area is numb, a small incision (less than 1 inch) will be made in the skin and the biopsy Fibrous Tissue Chest Wall This tissue extends from the needle will be inserted through the skin. A large group breast to the chest wall and of muscles that provides support for the breast The radiologist or surgeon will guide the needle into the fan out beneath area of concern by feeling the lump or by ultrasound. the breast over the ribs You may feel a slight pressure during the procedure, but Incision Site Mammary Glands Nipple you should not experience The part of The small projection of any significant pain. Once the the breast that the mammary gland sample is obtained, the needle produces milk that is transported through will be removed and the sample ducts to the nipple Lymph Nodes will be prepared and sent to a Soft bean-shaped pathologist for diagnosis. This Fat Tissue Duct structures that form the Tissue that forms a A tube that carries filtering devices that procedure may be repeated covering for the breast milk to the nipple drain body tissue fluids for additional samples, usually through the initial incision. However the actual injection of the tracer results in Not all women with breast cancer are candidates for only mild discomfort. Once the radioactive tracer is sentinel node biopsy. The following women are poor injected, a special instrument is used by the radiologist candidates: Sentinel Node to find the area of concentrated radioactive material • Women with lymph nodes that are enlarged (hot spot). This would be where the sentinel node is • Women with locally advanced breast cancer located. Usually he will mark the outer skin to indicate where the sentinel node is. At this point you are ready • Women with multi-focal breast cancer (in many Biopsy to go to surgery for the actual biopsy procedure. Once areas of the breast) in the operating room, the surgeon usually injects blue • Women who have previously undergone breast dye around the tumor site and the lymph fluid will also surgery carry it to the sentinel node. A small incision is made in • Women who have previously undergone radiation the axilla (armpit) and the surgeon looks for the lymph therapy to the breast node that is stained with the blue dye and may use a Sentinel node biopsy (SLNB) is not for everyone. special tiny probe that will tell with an audible signal While some patients are overwhelmingly enthusiastic precisely which node(s) contains the radioactivity. That about this procedure, it is important that you discuss node(s) is removed and sent to the pathologist for the pros and cons for you as an individual with your examination under a microscope for cancer cells. healthcare provider or cancer care team. It is also important that you feel confident that your surgeon is well experienced in sentinel node biopsy. Last, you At Home should be aware that there is a small chance (less than After surgery, your urine will be blue or green-blue 1 in 10 cases) that the results of the sentinel node for 24-28 hours.
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