A diagnosis of breast cancer typically requires a biopsy in order to microscopically examine tissue for cancerous cells. There are several kinds of biopsies, and the type used can depend on the size of the lump, location, the number of suspicious areas and patient medical history. A surgical biopsy is the most invasive kind of biopsy but can also be the most definitive.
Significance
The National Cancer Institute estimates that in 2009 in the United States there were approximately 207,090 women newly diagnosed with breast cancer and 1,970 men diagnosed with breast cancer. That same year, 39,840 women and 390 men died from the disease. Despite these statistics, the Mayo Clinic states that 80 percent of women who have a breast biopsy do not have cancer.
Features
A surgical biopsy involves removing the entire lump, along with a surrounding margin of tissue to ensure the whole tumor is removed. If the lump is too big to be completely removed, part of the tumor can be taken out; this is called an incisional biopsy. If the lump is too small to be felt, stereotactic wire localization may be done, using a hollow needle and X-ray to guide the needle to the lump. Once the lump is located, a wire is inserted through the needle so the surgeon knows where to remove the tissue.
Effects
Surgical biopsies typically involve more recovery than needle biopsies. Stitches are usually used with surgical biopsies, and these need to be kept dry until they are removed. Vigorous activities should be avoided for a few days to prevent bleeding, and some bruising and swelling are normal after surgery. Sometimes scar tissue forms after this surgery,which can feel hard during a breast exam.
Risks
There are some risks involved with a surgical biopsy for breast cancer. There will be a scar, and sometimes there is a distortion in breast shape, depending on how big the lump is, its location and the total amount of tissue removed. There are risks with anesthesia, but these are minimal because the procedure is very short, requiring little anesthesia.
Benefits
This type of biopsy involves removal of part or all of the lump, which makes it easier to make a definitive diagnosis of breast cancer because there is more tissue to examine. If the lump is benign, no further treatment is needed; if it is malignant, different characteristics can be determined such as the grade of the cancer, which helps guide prognosis, and hormone receptor and HER-2 status, which can help guide treatment options.
