Dr. Kolachalam, Breast Biopsy
What is a Biopsy?
- Biopsy is a technique for removing cells from a lump and examining them under a microscope to confirm a diagnosis.
- Visit the educational video below for your visual learning style.
Click here to know the 5 things you should question before a breast biopsy?
Biopsies may be done under local or general anesthesia. There are several types of breast biopsy procedures. The type of biopsy performed will depend on the location and size of the breast lump or abnormality.
- Fine needle aspiration biopsy may need to be performed the same day of your initial visit, depending on the type of lump you have. But, what is it?
- A very thin needle is placed into the lump or suspicious area to remove a small sample of fluid and/or tissue.
- No incision, or cut, is necessary.
- A fine needle aspiration biopsy may be done to help see if the suspicious area is a cyst (a fluid-filled sac) or a lump.
- Core Needle Biopsy may need to be performed the same day of your initial visit, depending on the type of lump you have. This technique that uses a computer and a transducer that sends out ultrasonic sounds waves to create images of the breast lump or mass. This technique helps to guide the needle to the exact biopsy site. How?
- A large needle is guided into a lump or suspicious area to remove a small cylinder of tissue (also called a core).
- No incision is necessary.
- Open biopsy is performed when the core biopsy is non diagnostic. After surgery, a small scar remains, but you’ll have little change in the contour of your breast. There are two types of surgical biopsies:
- During an incisional biopsy, a small part of the lump is removed.
- During an excisional biopsy, the entire lump is removed.
In some cases, if the breast lump is very small and deep and is difficult to locate, the wire localization technique may be used during surgery. With this technique, a special wire is placed into the lump under X-ray guidance. Dr. Kolachalam then follows this wire to help locate the breast lump.
There are special instruments and techniques that may be used to guide the needles and to assist with biopsy procedures. These include, but are not limited to, the following:
- Stereotactic biopsy: Stereotactic biopsy finds the exact location of a breast lump or suspicious area by using a computer and mammogram results to create a three-dimensional (3D) picture of the breast. A sample of tissue is removed with a needle that is guided to the right area using the 3D picture.
- Ultrasound Guided: A technique that uses a computer and a transducer that sends out ultrasonic sounds waves to create images of the breast lump or mass. This technique helps to guide the needle to the exact biopsy site.
**Ultrasound does not replace the need for mammograms on a very early cancer called “ductal carcinoma in situ” or DCIS. Often, this is only seen on mammograms as microcalcification. This requires a core biopsy with mammogram guidance.
- Sentinel node biopsy is a surgical procedure that Dr. Kolachalam uses to stage (determine the severity of) certain types of cancer in patients who have been recently diagnosed with cancer. Sentinel node biopsy is most commonly associated with staging breast cancer; however, the procedure is also commonly used to stage malignant melanoma (a type of skin cancer). The sentinel node is the one lymph node that the cancer spreads to first. If it is negative (no cancer), then you can avoid taking additional lymph nodes unnecessarily.
- During the procedure, Dr. Kolachalam usually removes 1 or 2 sentinel lymph nodes from the underarm of the breast involved with cancer and tests those nodes to determine if cancer cells have spread to them. If cancer cells are found in these lymph nodes, additional lymph nodes can be taken to help determine the prognosis. A sentinel node biopsy is a very important tool to determine what further treatment is necessary to get rid of the breast cancer, as well as what the patient’s prognosis is.