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Diagnosis

 
Diagnosis

Chapter: 4 - Diagnosis

Subchapter: 4 - Biopsy

A biopsy is a diagnostic procedure in which cells are removed from a suspicious area to check for the presence of breast cancer. There are three types of biopsy: fine needle aspiration, core needle biopsy, and surgical biopsy.

Let’s discuss the different types in greater detail.

Fine Needle Aspiration
(FNA)/Fine Needle Aspiration Biopsy (FNABx)

If the lump is easily accessible, or if the doctor suspects that it may be a fluid-filled cystic lump, the doctor may choose to conduct a fine needle aspiration (FNA). During this procedure, the lump should collapse once the fluid inside has been drawn and discarded. Sometimes, an ultrasound is used to help your doctor guide the needle to the exact site. If the lump persists, the radiologist or surgeon will perform a fine needle aspiration biopsy (FNABx), a similar procedure using the needle to obtain cells from the lump for examination.

Core Needle Biopsy
Core needle biopsy is the procedure to remove a small amount of tissue from the breasts with a larger “core” needle. Similar to fine needle aspiration, an ultrasound might be used to help your doctor guide the needle to the exact site. Once removed, the suspicious area tissue will be examined for traces of cancer.

Surgical Biopsy
(also known as wide local excision)
During a surgical (or wide local excision) biopsy, the doctor will remove all or part of the lump from the breast as well as a small amount of normal-looking tissue. This procedure is often performed in a hospital with the patient under local anesthesia. If the lump cannot be easily felt, an ultrasound might be used to help guide your doctor to the suspicious area. Once removed, the abnormal tissue will be examined for traces of cancer. The surrounding margin, or small amount of normal–looking tissue, will be examined to determine if the cancer has been completely removed.

Many times after core and surgical biopsies, a marker is placed internally at the biopsy site. This is done so that if further surgery is required, the surgeon can more easily locate the abnormal area.

Related Questions

  • kate eshleman Profile

    I had my drains removed Friday and understood some fluid under my mastectomy scars would be typical, but I actually look like I have small breasts again and it is uncomfortable. Is this typical?

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 7 answers
    • View all 7 answers
    • Anne Marie jacintho Profile
      anonymous
      Survivor since 2003

      Kate I had fluid build up post bilateral mastectomies my surgeon would manually drain the fluid with a syringe every other day for two weeks after my surgeries. I noticed the more I did with my arms the faster the bluish would build up. Also needed to sleep ony back propped up with pillows or in...

      more

      Kate I had fluid build up post bilateral mastectomies my surgeon would manually drain the fluid with a syringe every other day for two weeks after my surgeries. I noticed the more I did with my arms the faster the bluish would build up. Also needed to sleep ony back propped up with pillows or in a lazy boy recliner laying flat or on my side would also cause fluid buildup. In time the fluid build up will stop and reabsorb. Most important is if the areas is red and warm to touch or if you have a fever go to the emergency room as that could be a sign of infection take care

      Comment
    • Isabel Souchet Profile
      anonymous
      Survivor since 2010

      Hi I had fluid build up for a year after surgery. I still have a little but nowhere near as much as the first year. It is fairly typical. I always showed my oncologist and surgeon anything that bothered me, just to be safe. Not sure what can be done although I did have lymphatic drainage...

      more

      Hi I had fluid build up for a year after surgery. I still have a little but nowhere near as much as the first year. It is fairly typical. I always showed my oncologist and surgeon anything that bothered me, just to be safe. Not sure what can be done although I did have lymphatic drainage treatments done by a licensed person.

      Comment
  • Patricia Stoop Profile

    I previously posted about numbness after surgery. Thanks for answers. I bought a nice pair of high quality prosthetics and notice less discomfort and numbess when I wear them!

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 4 answers
    • View all 4 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      Great to hear! I also wear a prosthetic and after 5 years, it feels totally "normal". It is quite comfortable and I never go without it. It just feels weird if I don't where it. I am glad to hear you have found a way to be more comfortable. It sounds like the vast majority here have...

      more

      Great to hear! I also wear a prosthetic and after 5 years, it feels totally "normal". It is quite comfortable and I never go without it. It just feels weird if I don't where it. I am glad to hear you have found a way to be more comfortable. It sounds like the vast majority here have reconstruction whereas I never even considered it. This is probably because of my age but It is nice to hear of another woman who did not have reconstruction. When I was about to have the mastectomy, my surgeon who was a breast surgeon, asked me about reconstruction. I told her I had decided against it. She said she could make a
      "seat" where my prosthesis would fit. She did.... it is an area that the triangular prosthesis fits against my chest wall. I don't regret my decision as for me, it works well.
      Patricia, I am glad you are feeling better! Take care, Sharon

      4 comments
    • Marianne R. Profile
      anonymous
      Survivor since 2011

      I'm 58 and after 9 months of putting on my breast everyday and having some "boob free" days I have decided to do reconstruction the end of June. I hate that time of day I put my breast in the drawer with my bras, underware, slips, and hose. Recon isn 't for everyone but going without is not for...

      more

      I'm 58 and after 9 months of putting on my breast everyday and having some "boob free" days I have decided to do reconstruction the end of June. I hate that time of day I put my breast in the drawer with my bras, underware, slips, and hose. Recon isn 't for everyone but going without is not for everybody. We are all sisters and support everybody in their journey.

      2 comments
  • Lydia Bujanda Profile

    I was dx with dcis and opted for unilateral mastectomy. Final path report showed a small .4mm invasive tumor that had spread to breast and was triple negative. Now my onc wants to do chemo, isn't this too aggressive since I did have mastectomy?

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 6 answers
    • View all 6 answers
    • Thumb avatar default
      anonymous
      Learning About Breast Cancer

      So true Blair. I'm also triple negative. Did chemo then surgery and soon I'll begin rad therapy. Goal is to make sure there isn't even one of those horrible cells. Jayme

      Comment
    • Mary Foti Profile
      anonymous
      Survivor since 2010

      Your oncologist is not being aggressive -- he/she is being thorough. There is no follow up treatment after surgery, radiation and chemo if you have triple negative breast cancer. Medications like tamoxifen and Arimidex and herceptin don't affect triple negative; therefore your oncologist is wise...

      more

      Your oncologist is not being aggressive -- he/she is being thorough. There is no follow up treatment after surgery, radiation and chemo if you have triple negative breast cancer. Medications like tamoxifen and Arimidex and herceptin don't affect triple negative; therefore your oncologist is wise to suggest chemo because there is a very small chance the cancer may have already spread beyond the breast and the chemo should work to kill any of those before they get a chance to set up shop somewhere else in your body. A mastectomy is a wise move also, but it can't always prevent a recurrence by itself.

      Comment
  • marianne  hayes Profile

    should I delay my bilateral mastectomy to have reconstruction at the same time or have a 2-stage op? I'm so confused. I have a stage II from biop 18mm lump in the upper outside quadrant of my left breast.

    Asked by anonymous

    Learning About Breast Cancer
    almost 8 years 2 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      Hi Marianne. That's a very tough decision. You mentioned...should you delay having your bilateral mastectomy to have reconstruction. I'm just curious about the delay question. I didn't have the option for immediate reconstruction due to my late stage of cancer, it being in my chest wall, etc. I...

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      Hi Marianne. That's a very tough decision. You mentioned...should you delay having your bilateral mastectomy to have reconstruction. I'm just curious about the delay question. I didn't have the option for immediate reconstruction due to my late stage of cancer, it being in my chest wall, etc. I am almost finished with radiation and I will have reconstruction when I'm healed from that. I have heard both good and bad arguments both ways. I know when choosing expanders then implants, there's the chance of capsular contracture when doing radiation. Thats the negative. The positive is that when you wake from surgery...you will have something there. Another thing to consider is the fact that if you choose to wait...your skin tightens a good bit during radiation and your skin in the radiated area may not be enough to do the expanders & implants. But then of course you can choose another such as DIEP flap (which they'll do a mini tummy tuck as well) or another type. I am going to be visiting plastic surgeons soon Best wishes in whatever you decide. :)

      Comment
    • Wendy DeLong Profile
      anonymous
      Learning About Breast Cancer

      I am a stage 2A dx'd on 12/8/11. My tumor was 1.5 cm in left breast. I had left side mastectomy with expander insertion on Jan 9. For me the mastectomy was the first step in treatment. Starting the reconstruction at the same time was an option for me and I opted for it. I'm glad I did it. ...

      more

      I am a stage 2A dx'd on 12/8/11. My tumor was 1.5 cm in left breast. I had left side mastectomy with expander insertion on Jan 9. For me the mastectomy was the first step in treatment. Starting the reconstruction at the same time was an option for me and I opted for it. I'm glad I did it. Not because I still feel like I have a breast because this expander is a good ways from what I am thinking my perm implant will eventually look like...... But because I feel like its one less thing to do later. I am ER PR and HER -. My sentinal node did show some cancer while the remaining 12 were clean. My mastectomy biopsy found only precancerous cells in the area that surrounded the original tumor and nothing else in the whole breast. Last week I finished my 4th A/C which was my last. I start 12 weeks of Taxol on April 12 and then I will do 5 years of the hormone pill as well. Once I'm done the end if June with Taxol, ( if all goes well), I plan to do right side mastectomy with expander as soon as I am well enough. This has been the hardest thing I have ever had to do. I'm a go getter.... But this AC gives me a run!! But I just take my "medicine" because I have to. I have a loving supportive family and lots of friends praying for me. I am excited about starting the next step of my treatment as it puts me one step closer to being done.!! All your posts are an Inspiration to me. I wish you all the best! Love and prayers- :)

      Comment

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