A breast biopsy is a simple procedure that involves sampling tissue from an area of concern within the breast.As an alternative to open surgical biopsy, the Breast Center of Irvine offers minimally invasive breast biopsy procedures performed with ultrasound or mammographic guidance. We use a special vacuum-assisted needle to obtain multiple tissue samples through one small incision. One of three imaging methods is employed – stereotactic biopsy, ultrasound biopsy or Magnetic Resonance Imaging (MRI).
Ultrasound biopsies use high-frequency sound waves to create detailed breast tissue images.
FINE NEEDLE ASPIRATION / ULTRASOUND
Fine needle aspiration (FNA) is the least invasive method of biopsy and it usually leaves no scar. You will be lying down for this procedure. First, an injection of local anesthesia is given to numb the breast. The radiologist uses a thin needle with a hollow center to remove a sample of cells from the suspicious area. In most cases, he or she can feel the lump and guide the needle to the right place. A thin needle is placed into the lump. If fluid comes out, and the lump disappears, it means that the lump is a cyst and is usually not cancer. FNA however, does not allow these cells to be compared to surrounding tissue for the most accurate diagnosis.
CORE NEEDLE BIOPSY / ULTRASOUND
Core needle biopsy uses a larger hollow needle than what is used for fine needle aspiration. This type of biopsy is done while you are lying down. After numbing the breast with local anesthesia, the radiologist uses the hollow needle to remove several cylinder-shaped samples of tissue from the suspicious area. In most cases, the needle is inserted about 3 to 6 times so that the doctor can get enough samples. Usually core needle biopsy does not leave a scar.
If the lesion cannot be felt through the skin, the surgeon or radiologist may use an image-guided technique such as ultrasound-guided biopsy or stereotactic needle biopsy. A small metal clip may be inserted into the breast to mark the site of biopsy in case the tissue proves to be cancerous and additional surgery is required. This clip is left inside the breast and is not harmful to the body. If the biopsy leads to more surgery, the clip will be removed at that time.
Stereotactic biopsy use 3D tomosynthesis mammographic images to accurately locate breast abnormalities. This techniques is most frequently used for biopsy of calcifications or lesions that are apparent on the mammogram, but not on the ultrasound. The procedure requires local anesthesia and only low-dose radiation.
VACUUM-ASSISTED BREAST BIOPSY WITH 3D TOMOSYNTHESIS
Vacuum-assisted breast biopsy, unlike core needle biopsy, which involves several insertions of a needle through the skin, vacuum-assisted biopsy uses a special probe that only needs to be inserted once. The procedure is also able to remove more tissue than core needle biopsy.
For vacuum-assisted breast biopsy, you will be seated in a chair. First, an injection of local anesthesia is given to numb the breast. Guided by mammography (stereotactic-guided biopsy) the radiologist places the probe into the suspicious area of the breast. A vacuum then draws the tissue into the probe.
A rotating cutting device removes a tissue sample and then carries it through the probe into a collection area. The radiologist can then rotate the probe to take another sample from the suspicious lesion. This can be repeated 8 to 10 times so that the entire area of concern is thoroughly sampled. A small metal clip is placed into the biopsy site to mark the location, in case a future biopsy is needed. This clip is left inside the breast and causes no pain or harm. If the biopsy leads to more surgery, the clip will be removed at that time.
MAGNETIC RESONANCE IMAGING (MRI)
Magnetic Resonance Imaging (MRI) uses a specialized imaging magnet to create a high-resolution image using microscopic chemical and physical information about breast tissue molecules.