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What
happens when the test is performed?
- The first part of this procedure occurs in the mammography
department. Although you probably just recently had a mammogram,
a radiologist will perform another one to find the abnormal area.
While watching your x-ray on a screen, the radiologist will then
decide where in your breast the abnormality must be. He or she
will insert a needle into your breast in this area and will take
another mammogram picture that shows the needle in place, to
be sure the end of the needle is (hopefully) right in the middle
of the area of concern. The needle might require some adjustment
so that it is placed just right.
The needle is hollow and the radiologist can slide a small wire
right through it. This wire has a tiny fishhook on its end so
when the end of the wire reaches the point of the needle in your
breast, it can grab onto your breast tissue and hold itself in
place. Then the needle can be pulled out, sliding over the outside
end of the wire and leaving the wire in your breast.
You will be taken to the operating room for the second part of
the biopsy. You will have an IV (intravenous) line placed in
your arm so that you can receive medicines through it. Your procedure
may be done under either "local" or "general" anesthesia.
Local anesthesia is similar to the kind most people get at the
dentist —
a numbing medicine is injected in a few places under the skin
surface so that you won't feel anything in the specific area
that will be worked on during the surgery. General anesthesia,
on the other hand, causes you to be asleep and unconscious during
the procedure and is administered by an anesthesiologist. For
general anesthesia, you breathe a mixture of gases through a
mask. After the anesthetic takes effect, a tube may be put down
your throat to help you breathe.
An incision will be made in your breast right where the wire
sticks out of your skin. The surgeon will feel along the wire
and separate the breast tissue from the wire until he or she
finds where the end of the wire is hooked into your breast. The
surgeon knows that it is the area right at the end of the wire
that looks abnormal on your mammogram and needs removal. He or
she will take out a small sample of breast tissue from the area
surrounding the end of the wire — the wire will be removed
with the chunk since it will still be holding onto the middle
of it.
Any light bleeding is stopped with a wand-like instrument called
a "cauterizer"
that uses an electric current to seal the ends of bleeding blood
vessels. So that you do not feel any electric shock from the
cauterizer, your doctor will have attached a plastic pad to your
leg, back, or abdomen that works to ground the current.
While you are still in the operating room, your surgeon will
give the breast lump he or she has removed (still with the wire
attached) to your radiologist. The radiologist will take a special
x-ray of your removed lump of breast to see if it looks the same
as the spot that had worried him or her on your mammogram. Then
he or she can confirm for the surgeon that the correct piece
has been removed.
Right afterward, your surgeon might give the same piece of tissue
to a pathologist. The pathologist will put dye around the outside
of the lump and take a quick look at a few slices of the tissue
under a microscope. The pathologist can then tell the surgeon
if it looks like cancer or not. If there is cancer inside the
lump and if the cancer reaches out all the way to the edges with
the colored dye, the pathologist might advise your surgeon to
remove some extra tissue from around the edges, increasing the
likelihood that the whole cancer will have been removed. If enough
tissue has been removed to protect you, your surgeon will then
stitch your wound closed.
If you have had general anesthesia, you will have your anesthesia
stopped so that you can wake up within a few minutes of your
biopsy being finished.
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