What is a breast biopsy?
A breast biopsy is a simple medical procedure which involves taking tissue samples or fluid from a lump or area in the breast. These cells are then examined under a microscope and sent for further testing to check for traces of cancer.
Screenings such as mammograms and breast ultrasounds are useful in finding breast lumps but currently, a breast biopsy is the only way to know if the lump is cancerous. The good news is that not all lumps are cancerous and 80% of breast biopsies do not turn out to be cancer.
Why is a breast biopsy done?
A biopsy will usually be recommended if your doctor becomes concerned with the results from a routine breast examination, mammogram, ultrasound or Magnetic Resonance Imaging (MRI) or a concerning clinical finding.
A biopsy may also be ordered if you or your doctor feel a lump or thickening in the breast, and you have unusual nipple or areolar changes, such as bloody discharge, dimpling skin, crusting or scaling as these are all symptoms of a breast tumour.
Is a breast biopsy painful?
It is a relatively painless procedure. You may feel a slight discomfort in the area where local anaesthesia is administered but you should not feel pain during the biopsy itself.
What are the risks involved in a breast biopsy?
Potential risks could include an infection or bleeding in the area the biopsy was done, bruising and swelling of the breast, changes in appearance of the breast depending on how much tissue was removed and how the breast heals, and additional treatments or surgery depending on the results of the biopsy.
It is important to contact your doctor if you eventually develop a fever, experience any redness or warmth in the area of the biopsy, or if you have any unusual drainage from the biopsy area as these can be symptoms of an infection requiring immediate treatment.
How do you prepare for a breast biopsy?
Before a breast biopsy, do tell your doctor about any allergies you have, especially with regards to allergies or non-responsiveness to anaesthesia, and any supplements or medications you are currently taking including aspirin or other blood-thinning medications.
If an MRI scan is recommended by your doctor, do inform them of any electronic devices implanted in your body such as a cardiac pacemaker, or if you are pregnant or suspect you could be pregnant as an MRI whilst considered safe for adults, isn’t recommended for unborn babies.
Do wear a bra to your appointment as a cold pack may be placed against the biopsy area after the procedure to help with any inflammation and pain. Your bra can help keep the cold pack in place as well as provide support for your breast.
What breast biopsy procedures are there?
There are different procedures to do a biopsy and the method chosen depends on the location and size of the lump, whether there are multiple lumps, if you have other medical issues, and your personal preferences.
Fortunately, there are minimally invasive procedures and one of them is called mammotone.
What is a mammotone?
In a biopsy performed using a mammotome vacuum-assisted breast biopsy device, a special probe is used to make a small incision at the area of concern, then the probe gently vacuums, cuts and removes tissue through the hollow chamber of the probe for examination.
As several samples are acquired, this biopsy technique allows for highly accurate breast cancer diagnosis without the need for open surgery. As multiple samples are acquired without removing and reinserting the probe, this results in less internal scarring which then minimises interference with monitoring and diagnosis of breast abnormalities in the future.
After the breast biopsy, the incision area can be closed with an adhesive bandage instead of stitches. A biopsy using a mammotome device can be completed in less than an hour and is performed on an outpatient basis or in a doctor’s office without general anaesthesia.
What happens after the procedure?
Do leave the bandage on for 24 hours after the biopsy, and avoid showering during that time. Do not remove the transparent plastic dressing over the wound until 3 days after the biopsy. Painkillers may be taken if you feel pain or discomfort but do not take Aspirin or medications containing Aspirin. Do not participate in strenuous activities for 24 hours and no swimming for a week.
The biopsy results will typically take 2 – 3 days to be processed and will be sent to your surgeon. Do make an appointment with your surgeon to review the results of your biopsy and have the area examined.
In conclusion, whilst there are definitely many techniques for breast biopsy, there are differences in the levels of invasiveness, scarring, incision size, recovery time, types of anaesthesia and location where the procedure is performed.
It is very important to consult your doctor to find out which biopsy technique is the best fit for your situation.
Article reviewed by Dr Chong Chee Keong, general surgeon at Parkway East Hospital
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