What is a Breast Biopsy?
A breast biopsy is a medical procedure in which a small sample of breast tissue is removed and examined under a microscope to check for abnormalities, such as cancerous cells. It is typically recommended when a lump or other suspicious area is detected during a mammogram, ultrasound, or physical exam. The biopsy helps determine whether the abnormality is benign (non-cancerous) or malignant (cancerous).
Types of Breast Biopsies
- Fine Needle Aspiration (FNA): A thin, hollow needle is used to aspirate/suck out a small sample of cells or fluid from a lump in the breast. This is a minimally invasive procedure typically used for lumps that can be easily felt. Preferred for cystic lesions and tiny lesions which may not be feasible for a core needle biopsy.
- Core Needle Biopsy: A wide bore needle is used to sample a palpable lesion or one seen on breast imaging. A small cylinder (core) of tissue is sampled. This type of biopsy is advised over an FNA, as it provides more tissue for analysis, and may be more specific.
- Stereotactic Biopsy: This biopsy uses mammography to guide the needle to a precise area of concern in the breast, often used when calcifications or small abnormalities are seen on a mammogram but not seen/localizable clinically or on an ultrasound.
- Vacuum-Assisted Biopsy: A vacuum-powered device collects multiple tissue samples through a single needle insertion. This technique allows for the removal of larger tissue samples from a wider area, typically when there may be microcalcifications detected on breast imaging.
- Surgical (Open) Biopsy: A surgeon removes a portion of the lump or the entire lump during a surgical procedure, typically when a core biopsy is inconclusive, or the lesion requires to be excised.
Breast Biopsy Procedure
The breast biopsy procedure varies depending on the type of biopsy being performed, but it generally follows these steps:
- Preparation: The area of the breast to be biopsied is cleaned, and local anesthesia is applied to numb the area.
- Imaging Guidance: Imaging techniques such as ultrasound, mammography, or MRI may be used to guide the needle to the area that requires sampling.
- Tissue Removal: A needle is inserted into the breast to remove a sample of tissue. In the case of a surgical biopsy, the procedure is commonly scheduled in the operation theatre and may be done under sedation/general anaesthesia. An apt incision is taken, and the biopsy is done under direct visual guidance. This is usually a day-care procedure, where the patient recovers within an hour or two after the procedure.
- Sample Collection: The tissue sample is sent to a lab where it will be examined by a pathologist under the microscope, to check for abnormalities.
What Happens After a Breast Biopsy?
After the biopsy, the area is bandaged, and you may be asked to apply an ice pack to reduce swelling and discomfort. Some soreness, bruising, and minor bleeding at the biopsy site are common and typically resolve in a few days. Your doctor will provide instructions for post-procedure care, including:
- Avoiding strenuous activities: It’s advised to rest and avoid heavy lifting or physical exertion for at least 24 hours after the procedure.
- Keeping the biopsy site clean: Follow your doctor’s instructions on how to care for the site and when to remove any bandages.
What Not to Do Before a Breast Biopsy
Before your biopsy, your doctor may ask you to:
- Avoid Aspirin and Blood Thinners: These medications can increase the risk of bleeding, so you may be asked to stop taking them a few days before the procedure.
- Refrain from Using Deodorants or Lotions: On the day of the biopsy, avoid applying deodorants, powders, or lotions to the breast area, as they can interfere with imaging techniques like mammograms.
What Does a Breast Biopsy Reveal?
A breast biopsy provides critical information about whether a lump or abnormality is benign or malignant. The tissue sample is examined to check for cancer cells, abnormal growths, or other conditions that may require further treatment.
Complications of a Breast Biopsy
- Infection: Although rare, the biopsy site may become infected.
- Bleeding or Hematoma: Some bleeding or bruising at the biopsy site is common.
- Changes in Breast Appearance: Depending on the amount of tissue removed, there may be changes in the shape or texture of the breast.
Conclusion
A breast biopsy is a crucial diagnostic tool for detecting breast cancer and other abnormalities. There are several types of breast biopsies, ranging from minimally invasive needle biopsies to more extensive surgical procedures. Understanding the process, what to expect before and after the biopsy, and the potential outcomes can help you feel more prepared and informed. Always follow your doctor’s instructions to ensure a smooth recovery.