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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

  • Thumb avatar default

    I just had a lumpectomy and sentinel node biopsy positive. The doctor said that after my lumpectomy I would have radiation, but the sentinel node being positive makes me wonder what treatment would be best.

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 5 answers
    • View all 5 answers
    • vicki e Profile
      anonymous
      Stage 2B Patient

      Four years ago I was diagnosed with stage 2b idc. I also had two positive nodes. I had a mastectomy, chemo and radiation. my docs assured me that the chemo and rads would take care of the two positive nodes and did not remove them. Fast forward to march 1,2012 and my two positive nodes were now...

      more

      Four years ago I was diagnosed with stage 2b idc. I also had two positive nodes. I had a mastectomy, chemo and radiation. my docs assured me that the chemo and rads would take care of the two positive nodes and did not remove them. Fast forward to march 1,2012 and my two positive nodes were now nine positive nodes. I am doing chemo again. I am not a happy camper. I questioned the decision not to trove them but wish I had thrown an all out hissy fit and insisted. I don't think I would be going through this again. If you decide to insist on the node removal, don't apologize to anyone and stand your ground. I wish I had. Docs are human and make mistakes. Go with your gut because you know your body best. My doc thought I was being a whiny butt. I should have been a screaming banshee ! Good luck and keep us posted.

      Comment
    • Thumb avatar default
      anonymous
      Learning About Breast Cancer

      I was in the same situation. I was told before my lumpectomy I would only need radiation. My sentinel lymph nodes were positive so now I am having chemotherapy then radiation then femora for 5 years. Ask your surgeon. My surgeon told my husband about the need for chemotherapy right after he...

      more

      I was in the same situation. I was told before my lumpectomy I would only need radiation. My sentinel lymph nodes were positive so now I am having chemotherapy then radiation then femora for 5 years. Ask your surgeon. My surgeon told my husband about the need for chemotherapy right after he completed my surgery.

      Comment
  • Kristin Burghard Profile

    Should I take tamoxifen or have my ovaries removed?

    Asked by anonymous

    Learning About Breast Cancer
    over 7 years 2 answers
    • Anne Marie jacintho Profile
      anonymous
      Survivor since 2003

      Morning Kristen I pondered the same question in 2008. Did a lot of research saw an gyn oncologist and talked to a lot of other doctors. I also had a negative BRCA I and II Gene testing is the first requirement with a positive BRCA I and II for insurance to cover the removal of your ovaries. ...

      more

      Morning Kristen I pondered the same question in 2008. Did a lot of research saw an gyn oncologist and talked to a lot of other doctors. I also had a negative BRCA I and II Gene testing is the first requirement with a positive BRCA I and II for insurance to cover the removal of your ovaries. At least here in Hawaii. I was willing to pay for the procedure on my own at first. But after researching how estrogen is produced in your body I discovered that your ovaries are only partly producing estrogen you also produce estrogen from your adrenal glands so even with your ovaries removed you would still have to take some form of an estrogen blocker ... I still have my ovaries have been on tamoxifen for three years and am officially menopausal now so was switched to arimedix which I will take for another 5 years. I've read that there is research going on in finding another medication that breast cancer survivors will take for life. Have to say I was counting down two more years of tamoxifen so was hit with a hard blow when my doctor advised me to switch to arimedix for another 5 years. Took me a couple of months to warm up to the idea but bottom line is I really don't want another reoccurrence and if there is something that could possibly prevent it got to go with it. Take care

      3 comments
    • Karen Locklear Profile
      anonymous
      Learning About Breast Cancer

      I had to have my ovaries removed because I could not take tamoxifen. I had major side effects at first and then became allergic to it. After surgery, I am now on Femaria and other than bone pain, I am doing well taking it. I know a good many women that could not take tamoxifen for several...

      more

      I had to have my ovaries removed because I could not take tamoxifen. I had major side effects at first and then became allergic to it. After surgery, I am now on Femaria and other than bone pain, I am doing well taking it. I know a good many women that could not take tamoxifen for several reasons. I would have my ovaries removed if I were you. I hope this helps!!! God Bless You!!!

      2 comments
  • Thumb avatar default

    How long after surgery (double mastectomy) can you shower?

    Asked by anonymous

    Stage 1 Patient
    over 6 years 3 answers
    • Kathy Basham Profile
      anonymous
      Survivor since 2012

      I showered the next morning after I came home from the hospital. Just wore a little apron with pockets to hold my drain bulbs and then pat dry and blow dry well. Sure makes you feel better :) -prayers for complete healing and restoration.

      Comment
    • michelle j Profile
      anonymous
      Patient

      I had mine on Thursday and showered today - sponged bathed the other days. The biggest reason I waited was because I was nervous.

      Comment
  • beth poyner Profile

    I am set to have a one step nipple saving double mastectomy on 8/24. Has anyone had this procedure and if so did you have any complications?

    Asked by anonymous

    Learning About Breast Cancer
    about 7 years 6 answers
    • View all 6 answers
    • Thumb avatar default
      anonymous
      Stage 0 Patient

      I had this surgery on July 6th. It went great! I had an excellent surgeon and plastic surgeon. I went with silicone implants. They are safe and the doctor recommended them. I would ask how many of these procedures your plastic surgeon has performed and if he has any pictures of people after the...

      more

      I had this surgery on July 6th. It went great! I had an excellent surgeon and plastic surgeon. I went with silicone implants. They are safe and the doctor recommended them. I would ask how many of these procedures your plastic surgeon has performed and if he has any pictures of people after the procedure. This will help you see how you will look. I was in a lot of pain after the procedure for a couple of weeks. It really does take time to get over it. Take it slow and listen to your body. I was showering two days after with my husband's help. If you don't already have one, get one of those shower heads that you can adjust and is handheld. My shower has a seat built in and so that helped. My PS also used Alloderm when he put in the implants, which he said helped to cradle the implants and make them feel more natural. There is a slight risk of your skin dying, but that did not happen to me. Overall, I am extremely pleased with the implants. They are different, but they look better than what I had before :-) I only had an incision above the nipple. You will be swollen and the breasts will shift some and get settled so they look slightly different after 6 weeks. The drains were absolutely the worst part of the whole thing and when I finally got those removed, I felt like I was really healing much better. Every person is different and every person's body heals differently. I began driving after about 5 weeks. I wore my husband's t-shirts or button down shirts for a few weeks because I had trouble lifting my arms. Your breasts and underarms will be numb. My left side is beginning to gain some feeling, but my affected side is taking longer to recover. Get a good electric razor! I had lymph nodes removed, so read about precautions you must take to avoid lymphedema. I have not had any complications so far. Also get a good sports bra that zips or fastens in the front. I have been wearing one made Danskin and purchased at Wal-Mart. They zip up the front and have very good support. After wearing it all day, it can rub the wrong way some so I wear a cami underneath. Don't get the cami with the built in shelf bra, though. That is irritating. The breasts are different than natural breasts in that they are wider and more round so buying a bra was different. When I went to purchase a bra, I went to Victoria's Secret. They have a great selection on non-padded bras of great quality. I do wear one for a short period of time, but I still feel more comfortable in the sports bra. I am back to light exercise and brisk walking, although still sore. Doctor says not to run yet. I have been very blessed. I have learned what so many have said. Breast Cancer is indeed a journey and every journey is different, but we can learn so much from others. I hope your experience is without complication and if you get down about it, say out loud, "My cancer is gone!" That is the blessing in all of it. Prayers for you!! P.S. If you are interested in a medical ID bracelet for lymphedema alert Lauren's Hope has some really cute ones. I found them online.

      Comment
    • Karen Heilman Profile
      anonymous
      Learning About Breast Cancer

      I had this procedure done on May 22 and have had no complications relating to the surgery. I would say, though, that it's crucial for you and your doc to be on the same page about the surgery and what your expectations are. Because you are having a one step process and going straight to...

      more

      I had this procedure done on May 22 and have had no complications relating to the surgery. I would say, though, that it's crucial for you and your doc to be on the same page about the surgery and what your expectations are. Because you are having a one step process and going straight to implants rather than expanders, you need to make sure you have clearly communicated your desires to your doctor. Try to be clear about your vision for your "new" body in terms of size, etc.

      A lot depends on how the surgery goes, the condition of the skin once the mastectomy is completed, and the skill of your surgeon. It's not possible for any doctor to tell you exactly what you will look like afterward. Also understand that even if the procedure goes perfectly and they are able to save your skin, aureolas, and nipples, the resulting reconstructed breast will not look or FEEL like your natural breasts to you. You'll still be you, but different.

      I hope this helps a little. Please let me know if there is anything else you'd like to know. Prayers and good luck to you!!

      Comment

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