Minimally Invasive Breast Biopsy
We offer several options for obtaining a minimally-invasive outpatient
breast biopsy, all here in the calm setting of the Washington Women's Center.
The goal of breast cancer screening is to try to detect cancers at an early
stage when they are most treatable and curable. Physical examination,
mammography, ultrasound and breast MRI all play important roles in the
detection and evaluation of breast lesions. In many cases lesions can
be characterized as benign or probably benign and safely followed with
short interval follow up examinations. In other cases, however, the lesions
may be suspicious for cancer or fall in a 'grey zone' where they
could be either benign or malignant. Obtaining a sample of the tissue
for analysis is necessary in these circumstances.
Jason Cheng, MD, radiologist, medical director, Washington Hospital Medical
Traditionally, most breast biopsies were done with a surgical procedure
and an excisional biopsy where the surgeon goes in and removes the lesion.
If the abnormality is not palpable, this may be done following localization
of the area of concern using ultrasound, mammography or MRI. Your radiologist
would mark the area of concern with the injection of a blue dye and placement
of a fine wire to help direct your surgeon to the correct area.
Excisional biopsy is sometimes the best or only choice. However, in many
cases today, lesions can be effectively sampled with a much less invasive
procedure. Instead of a standard surgical incision and removal of the
lesion, many lesions can be sampled with
special vacuum-assisted needle biopsy devices. Only a small skin incision,
much smaller than that required for an excisional biopsy, is needed to
allow the introduction of the needle. The procedure is done under local
anesthesia similar to that used in dental procedures. There should be
very little discomfort from the biopsy itself. There tends to be very
little scarring and deformity from vacuum-assisted core needle biopsy.
Only minimal recovery time is required.
The actual biopsy is done under imaging guidance. Depending on the type
of lesion, this may be done under ultrasound guidance, with a stereotactic
unit (special type of mammography machine that allows targeting of a lesion
in three dimensions), or under MRI guidance. In many cases, a tiny marker
will be left in the breast to denote the area of the biopsy in case it
should be necessary to re-excise the area in the event that the lesion
turns out to be
malignant or pre-malignant.
The specimens obtained are submitted to pathology for analysis where they
are processed and evaluated. The results are typically available in two
working days and will be sent to your referring doctor. After the biopsy
you will be sent home with some simple postprocedure instructions and
will follow up with your referring physician.