Biopsy has been a feared term for a long time, mainly due to its designation as a gold standard for cancer diagnosis. To clarify the former, a biopsy may not always mean cancer.
A breast biopsy is a minor procedure wherein a small sample from a breast lump is taken and tested for the nature of its cells.
Why the procedure?
Breast, as we are aware, are organs holding mammary glands in females for feeding of the newborn. The procedure is performed to find out the nature and origin of the lump found in the breast after verbal questions and physical examination. A biopsy is also recommended even when some physical changes appear in nipples like:
- Reddish discharge
- Dimpled nipple
- Crusting of nippular area
- Drying, scaly or cracked nipples
Types of biopsies:
- Using a needle
1. Fine needle Aspiration
A hollow very thin long needle is inserted into the affected area of the breast and the sample is collected and sent to the lab for investigation.
2. Core Needle Aspiration
A much larger needle is used for sample collection.
- Ultrasound-guided core biopsy
The needle placed for sample collection is guided through sonography for the exact sample collection place location. MRI can also be used to guide the needle here.
1. Stereotactic biopsy
A radiologist examines the area of sample collection through mammograms. Local anaesthesia is then injected and a small cut made, the needle is then inserted to collect the sample.
- Using an incision
1. Surgical biopsy
In this kind of procedure, the cancerous part is entirely removed after the surgical opening of the breast, a part or whole tissue from the removed lump is sent for testing.
2. Lymph Node Biopsy
While surgically removing the tumor, the closer axillary lymph nodes are tested through either needle biopsy, or sentinel lymph node biopsy and/or an axillary lymph node dissection.
This decision is mostly made depending on:
- Size of tumor
- Location of tumor
- Number of lumps
- Overlapping medical conditions
- Personal preferences
Core Needle biopsy is the most widely preferred for breast cancer.
The risk posed by the procedure:
A breast biopsy is a minor procedure and poses a minimum risk, however, some reported observations after biopsy includes –
- Change in the shape of the breast due to the removal of a part for biopsy
- Site Infection
Most of the effects are brief and cures on their own. A few that may prolong gets better with mild symptomatic local applications and treatment.
Your doctor guides you to the preparation. You need to fill in your medical history, the allergy details, and more. All drugs need to be stopped as per approval from your clinician. On the day of surgery, you need to wear a well-fitted bra.
The area of biopsy is marked after taking an appropriate scan or simultaneously. The sample is then taken from the marked area according to the previously approved procedure.
After the needle procedure, the patient can go home the same day, in open excisional case mostly the next day.
Mostly comes within 72 hours
The next plan of action is picked from there.
I cannot stress the fact more that the best results are assured if breast cancer (if at all) is detected at an early stage. There are plenty of examples around us of people who have collected themselves from the claws of breast cancer and came out as winners. A breast biopsy is just another diagnostic procedure.
Dr. Atul Srivastava, Senior Consultant – Oncology, Surgical Oncology, Dharamshila Narayana Superspeciality Hospital, Delhi