The National Cancer Institute estimates that in 2010, over 200,000 women will be diagnosed with breast cancer. They further state that a biopsy is the only way to be certain that cancer is present or not. This procedure involves the physical removal of breast tissue and the analysis of the tissue by a trained medical doctor. There are a few different types of biopsy procedures, which differ in the way a sample of breast tissue is removed.
Fine-Needle Aspiration
The American Cancer Society explains that this type of breast biopsy involves the use of a very thin needle that attaches to the end of a syringe. A medical doctor specializing in pathology, radiology, or surgery performs this procedure. The needle used is very thin, even thinner than the typical needle used to withdraw blood for blood tests. This procedure is often done without anesthetic because the needle is so thin; the needle used for anesthetic is even thicker, and causes more pain upon injection.
If the doctor can feel a lump, he can guide the needle by palpating, which means feeling the breast in specific manner. If the doctor cannot feel the suspicious area identified by other imaging technique, he may perform the needle biopsy by viewing the breast tissue by ultrasound, or he may conduct a stereotactic fine needle aspiration biopsy. In this procedure, x-rays are used to take images of the breast at two different angles. A computer then calculates the exact location of the cells of interest. Once the doctor finds the cells of interest, the aspiration needle is inserted into the breast tissue at the appropriate location, and a very small amount of cells are removed with the syringe. A small bruise may remain, but this procedure does not cause a scar.
Core Biopsy
The American Cancer Society explains that this procedure uses a slightly thicker needle that is specially designed to withdraw a cylinder of breast tissue. First, the doctor administers anesthesia so that the breast is numb. The needle is injected several times, often three to six, in order to get different core samples of breast tissue. Similar to a fine-needle biopsy, the doctor guides the core needle by palpating the breast, ultrasound, or by taking x-ray images to stereotactically locate the regions of interest. A doctor recommends this type of biopsy when he would like to examine more breast tissue than a fine-needle aspiration biopsy can remove. This procedure may cause bruising, but no scarring.
Surgical Biopsy
The National Cancer Institute explains that the procedure for this type of biopsy involves either local or general anesthesia, which is administered by an anesthesiologist. The surgeon makes an incision in the breast to locate and remove the tissue of interest. An incisional biopsy involves the removal of only a portion of the lump or area of interest. A doctor can then examine the tissue and decide if more tissue should be removed and whether cancer is present. In an excisional biopsy, more of the breast tissue is removed: the entire lump or area of abnormal tissue is excised. Once the tissue is removed, the surgeon closes the wound and applies stitches to the skin. This procedure will leave a scar, though the surgeon minimizes the size of incision whenever possible.
