Education For Healthy Life

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease). A biopsy is specified by the technique and/or size of needle used to collect the tissue sample.

• A fine needle aspiration biopsy (FNAB) uses a small needle to remove a small sample of cells.
• A core needle biopsy uses a larger needle to remove a larger sample of tissue. This is usually the preferred biopsy technique for determining whether a physical exam or imaging finding is cancer. A vacuum-assisted biopsy removes multiple large cores of tissue.
• A surgical biopsy removes the largest amount of tissue. This biopsy may be incisional (removal of part of the lump) or excisional (removal of the entire lump). Because definitive surgery is optimally done after a cancer diagnosis has been made, a surgical biopsy is usually not the recommended approach to determining whether an abnormality is cancerous. If a surgical biopsy confirms cancer, then further surgery is usually required to remove remaining cancer in the breast and evaluate the lymph nodes. Therefore, in order to keep surgery to one operation, it’s best when a patient receives a core biopsy to diagnose the cancer, followed by the type of cancer surgery with the best chance at removing all of the disease, as determined by the doctor.
  
• Image-guided biopsy is used when a distinct lump can’t be felt, but an abnormality is seen on a radiologic image such as a mammogram. During this procedure, a needle is guided to the area of concern with the help of mammography, ultrasound, or MRI. A stereotactic biopsy is performed with mammography guidance. A small metal clip may be put into the breast to mark the site of biopsy, in case the sample tissue proves cancerous and additional surgery is required. An image-guided biopsy can be done using a fine needle, core, or vacuum-assisted biopsy, depending on the amount of tissue being removed.

If cancer is diagnosed, surgery is needed to remove the cancer in the breast and evaluate the lymph nodes for the presence of cancer (discussed in the Treatment section). The goal is to achieve clear surgical margins (no cancer cells at the edge of the tissue removed during surgery). If lymph nodes show evidence of cancer, the cancer is called lymph node-positive breast cancer (or node-positive for short); if the lymph nodes do not show evidence of cancer, the cancer is called lymph node-negative breast cancer (or node-negative for short).