Stereotactic Biopsy of the Breast (Breast
Core Biopsy)
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What is the test?
This method uses a larger needle than the one used for a fine needle
aspiration, to increase the amount of tissue that can be removed for
microscopic examination. Large core needle biopsy is often performed
using either x-rays or ultrasound to show where the tip of the needle
is. Since the early 1990s, large core needle biopsy has been the diagnostic
method of choice to evaluate abnormalities that are visible on a mammogram
but cannot easily be felt by hand. In the more advanced medical centers,
this technique is considered the standard of care. However, core needle
biopsy may not be suitable for women who have an irregularity close to
the chest wall, the nipple, or the surface of the breast; those with
calcifications that require magnification; or women with very small breasts.
In these situations, accurate results may not be possible. Instead, your
doctor may recommend a surgical biopsy.
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How do I prepare for the
test?
If you take blood thinners or NSAIDs, you might have to stop using them
for several days before the test to avoid bleeding complications. If
you've had an allergic reaction to lidocaine or a similar local anesthetic,
let your doctor know this before having the test.
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What happens
when the test is performed?
You wear a hospital gown that is open in the front. The needle used
during a core biopsy is about as thick as a pen tip. It usually is placed
into the breast through a tiny incision that has been made in the skin
of the breast. Using mammogram or ultrasound images as a guide, or by
feeling the lump, the doctor moves the needle into the area of concern.He
or she removes one or more tissue samples through the needle with the
help of suction from a syringe.
If mammograms or ultrasound are used to guide insertion of the biopsy
needle, the required equipment should be in the same room. If your doctor
is using a special kind of x-ray procedure called a stereotactic biopsy,
you'll lie on your stomach on a special x-ray table. This table has an
opening that allows your breast to hang down during the procedure. An
x-ray (mammogram) is taken, and a computer determines the position of
the suspicious tissue inside your breast. Then, the computer guides the
tip of the biopsy needle directly to the suspicious tissue. Although
the biopsy itself takes only a few minutes, the entire stereotactic procedure
takes 20-40 minutes. Women who cannot remain still for that long because
of physical illness or other problems are not good candidates for stereotactic
core needle biopsy.
In an ultrasound-guided core needle biopsy, the radiologist uses ultrasound
imaging to precisely con- firm the location for biopsy. The doctor makes
only a single puncture in the skin to extract three to six separate core
needle tissue samples for analysis. This procedure takes only a few minutes,
and you should feel pressure but not pain.
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What risks are there
from the test?
After the biopsy, you might have a small amount of bleeding or bruising
and some breast soreness. This procedure leaves only a tiny dot for a
scar.
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Must
I do anything special after the test is over?
No. After a core needle biopsy is completed, the doctor may place a
bag of ice on the site for 15–30 minutes.Most likely, you'll be
able to resume normal activity almost immediately afterward.
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How
long is it before the result of the test is known?
Examination of the biopsy sample usually requires several days. At centers
where physicians are experienced in these biopsies, 65% of women who
undergo this procedure are diagnosed with a benign condition and can
resume having annual mammograms. Another 25% have a malignancy or a premalignant
condition and proceed with treatment. For the remaining 10%, results
are inconclusive; in most of these cases, the next step is a surgical
biopsy.
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