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Breast biopsy is a procedure when
a sample of breast tissue is taken and examined under a microscope for signs
of cancer. A breast biopsy is usually done to evaluate a lump found during
a breast exam or to study a suspicious area found on a mammogram.
There are several ways of performing a breast biopsy:
A
fine-needle aspiration biopsy is done by introducing a thin needle into the suspicious
lump and removing cells that are then examined under a microscope.
Needle aspiration is sometimes done to distinguish between a solid lump and a fluid-filled lump (cyst). If the lump is a cyst, it will collapse and disappear after
the fluid is removed. If there is little or no fluid, the lump probably is
not a cyst and another type of biopsy will need to be done.
A
core needle biopsy is done by using a large needle fitted with a special
cutting tip. As the needle goes through the skin toward the lump (or suspicious
area found during a mammogram or breast ultrasound), it collects a core of tissue
about the size of a pencil lead.
A stereotactic biopsy is done to evaluate a lump that
cannot be felt on breast examination, but is seen on mammogram or ultrasound. It is done using a special
type of X-ray instrument
that can precisely locate the area of the breast from which the biopsy sample is to be taken.
A small incision
is then made in the skin of the breast and a needle is guided by the instrument
to the exact biopsy site to collect a tissue sample. Stereotactic biopsy
may not be appropriate for all types of breast lumps.
An
open biopsy is done by making an incision in the skin
and then removing a sample of the suspicious lump, or the entire lump. If the
lump turns out to be cancerous, all or part of the breast can be removed immediately
(however, this is not commonly done). If the doctor cannot feel an obvious
lump, a needlelike probe can be placed in the suspicious area during a mammogram
done just before surgery. The probe then guides the doctor to the correct
area for collecting a biopsy sample.
Breast Biopsy
Results
Normal:
No abnormal or cancerous cells
or tissue are found.
Abnormal:
The most common noncancerous (benign)
abnormal findings are
fluid-filled cysts, lumps of the fibrous tissue that
connects and supports
breast tissue (fibrocystic lumps), and firm tumors of the gland tissue in
the breast (fibroadenoma). Solid benign lumps (such as fibroadenomas) may
be removed or left in place and watched closely. They do not go away, but
they are unlikely to become cancerous.
Other
noncancerous abnormal results include growths of fat tissue
(lipoma), scar tissue that contains calcium (calcification), an
abscess, or an overgrowth of cells called atypical ductal hyperplasia. Atypical ductal hyperplasia
may increase a woman's chance of developing cancer. If atypical ductal hyperplasia is found, an open
biopsy is needed to rule out cancer.
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