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Concept
Breast biopsy
Summary
A breast biopsy is usually done after a suspicious lesion is discovered on either mammography or ultrasound to get tissue for pathological diagnosis. Several methods for a breast biopsy now exist. The most appropriate method of biopsy for a patient depends upon a variety of factors, including the size, location, appearance and characteristics of the abnormality. The different types of breast biopsies include fine-needle aspiration (FNA), vacuum-assisted biopsy, core needle biopsy, and surgical excision biopsy. Breast biopsies can be done utilizing ultrasound, MRI or a stereotactic biopsy imaging guidance. Vacuum assisted biopsies are typically done using stereotactic techniques when the suspicious lesion can only be seen on mammography. On average, 5–10 biopsies of a suspicious breast lesion will lead to the diagnosis of one case of breast cancer. Needle biopsies have largely replaced open surgical biopsies in the initial assessment of imaging as well as palpable abnormalities in the breast.
There are many reasons why a doctor may order a breast biopsy. Typical indications include:
A suspicious area on mammography or ultrasound. This may include:
Microcalcifications on MRI.
BI-RADS score of 4 or 5 on mammography, ultrasound, or MRI.
A suspicious hard palpable lump
Skin changes like crusting, scaling, or dimpling of the breast, which may signal an underlying breast cancer
Abnormal nipple discharge
Fine-needle aspiration
Fine-needle aspiration (FNA) is a percutaneous ("through the skin") procedure that uses a fine needle and a syringe to sample fluid from a breast cyst or remove clusters of cells from a solid mass. It is mainly used to differentiate between a cyst and a mass. If the aspirated contents are not cyst-like, then a tissue sample must be taken to better evaluate the mass. Fine-needle aspiration is one of the most commonly used initial diagnostic tools for suspicious lesions. The doctor will typically use a 22 or 27 gauge needle to aspirate out free fluid and cells. It can be done in an outpatient setting and is associated with minimal pain.
Official source
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