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Biopsies

 

A biopsy is the removal of tissue in order to examine it for disease. The tissue samples can be taken from any part of the body. Biopsies are performed in several different ways. Some biopsies involve removing a small amount of tissue with a needle while others involve surgically removing an entire lump, or nodule, that is suspicious.

 

Often, the tissue is removed by placing a needle through the skin (percutaneously) to the area of abnormality. Biopsies can be safely performed with imaging guidance such as ultrasound, x-ray, computed tomography (CT), or magnetic resonance imaging (MRI). These types of imaging are used to determine exactly where to place the needle and perform the biopsy.

 

 

When a nodule is detected, imaging tests may be performed to help determine if it is benign (non-cancerous) or malignant (cancerous). If imaging studies cannot clearly define the abnormality, a biopsy may be necessary.

 

Breast biopsy is used to determine if a lump in the breast is cancerous or benign. It can be performed a number of ways:

  • Stereotactic (mammographically-guided)
  • Ultrasound-guided
  • MRI-guided

 

 

Ultrasound guidance is used in four biopsy procedures:

  • fine needle aspiration (FNA), which uses a very small needle to extract fluid or cells from the abnormal area.
  • core needle (CN) which uses a large hollow needle to remove one sample of breast tissue per insertion.
  • vacuum-assisted device (VAD) which uses a vacuum powered instrument to collect multiple tissue samples during one needle insertion.
  • wire localization, in which a guide wire is placed into the suspicious area to help the surgeon locate the lesion for surgical biopsy.

 

What are the benefits vs. risks?

Benefits

· The procedure is less invasive than surgical biopsy, leaves little or no scarring and can be performed in less than an hour.

· Ultrasound imaging uses no ionizing radiation.

· Ultrasound-guided breast biopsy reliably provides tissue samples that can show whether a breast lump is benign or malignant.

· Compared with stereotactic breast biopsy, the ultrasound method is faster and avoids the need for ionizing radiation exposure.

· With ultrasound it is possible to follow the motion of the biopsy needle as it moves through the breast tissue.

· Ultrasound-guided breast biopsy is able to evaluate lumps under the arm or near the chest wall, which are hard to reach with stereotactic biopsy.

· Ultrasound-guided biopsy is less expensive than stereotactic biopsy.

· Recovery time is brief and patients can soon resume their usual activities.

 

Risks

· Because the vacuum-assisted device removes slightly larger pieces of tissue than other types of needles, there is a risk of bleeding and forming a hematoma, or a collection of blood at the biopsy site. The risk, however, appears to be less than one percent of patients.

· An occasional patient has significant discomfort, which can be readily controlled by non-prescription pain medication.



· Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.

· Doing a biopsy of tissue located deep within the breast carries a slight risk that the needle will pass through the chest wall, allowing air around the lung that could collapse a lung. This is a rare occurrence.

 

 


Date: 2014-12-21; view: 841


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