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Cancers :
Breast Biopsy

Breast biopsy is the excision of a small amount of suspicious tissue from a breast for examination. The cells are usually examined under a microscope for signs of cancer.

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1. Which doctor will do a breast biopsy?

Usually it is a General surgeon or Radiologist, now there are surgeons with special interest in breast surgery.

2. Will the cancer spread after biopsy?

No, the chances of spread are minimum after a biopsy.

3. Will my breast get disfigured after biopsy?

No, the breast will not get disfigured after biopsy procedure.

4. How do you do a Stereotactic mammography?

Stereotactic mammography involves using computers to pinpoint the exact location of a breast mass based on mammograms (x-rays) taken from two different angles. The computer coordinates will help the physician to guide the needle to the correct area in the breast.

5. How do you perform an Ultrasound imaging guidance?

In Ultrasound imaging guidance, the radiologist or surgeon will view the needle on the ultrasound monitor to help guide it to the area of biopsy. FNAC is usually performed under ultrasound image guidance.

6. How do Breast FNAC samples appear?

Fluid collected from the breast lump may be clear, straw-colored, green or brown tinged, white, yellow, or more rarely, bloody. In most cases, these fluids are benign (non-cancerous). If the fluid is not bloody, it is usually simply discarded as it is mostly considered to be non-cancerous.Bloody fluid may indicate cancer and is usually sent to the laboratory for analysis

7. What are the Advantages and Disadvantages of FNAC Breast biopsies?

FNAC is the fastest and easiest method of breast biopsy, and the results are rapidly available.

FNAC is excellent for confirming breast cysts, and since the procedure does not require stitches, patients are usually able to resume normal activity almost immediately after the procedure.

Disadvantage of FNA is that the procedure only removes very small samples of tissue or cells from the breast. If the sample is benign fluid (for example, a cyst), then the procedure is ideal.

8. What are the Advantages and Disadvantages of FNAC Breast biopsies?

However, in cases when the tissue is solid or if a sample of cloudy, then the results of the test allows only for a cytological (cell) diagnosis. This can be an incomplete assessment because the cells cannot be evaluated in relation to the surrounding tissue.

9. What are the advantages and disadvantages of Core needle biopsy?

Core needle biopsy usually allows for a more accurate assessment of a breast mass than fine needle aspiration (if the sample is found to be solid or cloudy, suspicious-looking fluid) because the larger core needle usually removes enough tissue for the pathologist to evaluate abnormal cells in relation to the surrounding small sample of breast tissue taken in the specimen.

Disadvantage of CNA, is that it allows only samples of a mass and not the entire area of concern. Therefore, it is possible that a more serious diagnosis may be missed by limiting the sampling of a lesion (abnormality).

10. What are the advantages and disadvantages of Vacuum - Assisted Biopsy?

A relatively new biopsy procedure which is able to remove approximately twice the amount of breast tissue compared with core needle biopsy with minimum invasive breast biopsy procedure.

Vacuum-assisted breast biopsy is becoming more common but requires a highly skilled radiologist or surgeon who is experienced in performing the procedure.

Some patients are not good candidates for vacuum-assisted biopsy or may have lesions (breast abnormalities) that are difficult to locate with minimally-invasive equipment.

11. Why is the use of Large core Biopsy controversial?

Some breast radiologists feel that the large core biopsy (ABBI) procedure is not an appropriate method of breast biopsy. Unlike open surgical biopsy, in which the surgeon only removes a narrow strand of breast tissue in order to reach the lesion, large core biopsy (ABBI) requires the removal of a significant portion of normal breast tissue just to reach the lesion. Critics of large core biopsy (ABBI) say that the procedure removes unnecessary normal breast tissue and does not remove an adequate margin of tissue around the breast lesion for laboratory analysis.

12. What is the Post-biopsy care required after open surgical biopsy?

Open surgical biopsy requires stitches and a longer period of recovery than percutaneous ("Through the skin") breast biopsy procedures (such as fine needle aspiration (FNA), core needle biopsy, or vacuum-assisted biopsy). Usually, at least one full day of recovery is required.

13. What is the Post-biopsy care required after open surgical biopsy?

The scar from a surgical biopsy is typically small. However, whether or not surgery will change the shape of a womens breast depends on a number of factors like:

1.The size of the breast lesion.

2.The location of the breast lesion.

3.The amount of surrounding breast tissue that is removed in addition to the lesion.

14. What are the advantages and disadvantages to open surgical biopsy?

Surgical biopsy yields the largest breast tissue sample of all the breast biopsy methods, and the accuracy of a diagnosis using the open surgical method is close to 100%, making it the "gold standard" of breast biopsy methods.

Disadvantages of Open Surgical Biopsy is it requires stitches and can leave a scar formation within the breast and the scar may persist for 12 months or longer and complicate the interpretation of follow up mammograms. Rare complications of the procedure include chances of bleeding, infection, or problems with wound healing.

15. How does X-ray guided biopsy equipment look like?

The X-ray guided biopsy equipment has a specially designed table, in which the patient is made to lay face-down with her breast projecting through a hole in the table.

The biopsy is done below the table after raising it to gain access to her breast. The procedure also may be done with the patient upright in a chair, but she must not move during the procedure.

An upright study may be best for those women who might have difficulty climbing onto the table, or who are unable to lie prone for some reason.

16. How does X-ray guided biopsy technique captures image?

This procedure is done by specially trained technologists and physicians.

X-ray exposure to the breast is reduced by using computerized or digital imaging in place of film cassette, which permits the images to be viewed on a computer monitor seconds after exposure compared with the several minutes needed to develop x-ray film.

The great advantage of the procedure is that a lesion can be located precisely in three dimensions by calculating its apparent change in position on angled x-ray images.

The first x-ray locates the abnormality in the breast, after which two stereo views are obtained; each angled 15 degrees to either side of the initial image.

The physician then marks the lesion electronically on the stereo images and the computer calculates how much the lesions position appears to have changed on each of the stereo views, and in this way is able to determine its exact site in three-dimensional space.

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