Once a lump has been detected by a diagnostic tool such as a mammogram, it then becomes necessary to determine if the lump is malignant (cancerous) or benign. To do this, a sample of the suspicious lump must be taken and the cells within the sample analyzed. This sampling of tissue is known as a biopsy, and there are many ways to conduct such a procedure. There are many types of lumps that may be sampled, and depending on their size, location in the breast, and whether or not they were detectable on other diagnostic tests, a number of possible biopsy techniques may be used.
Ultrasound Core Biopsy (USCB)
If a lump appears solid according to the ultrasound tests, then the specialist may elect to take a tissue sample of the lump known as a biopsy. In this procedure, ultrasound is used to locate the lump within the breast, provided it is close to the outer layer of the tissue. Once located, the breast is anaesthetized and a needle is used to penetrate the lump in question and withdraw a tissue sample for further study. Once again, this procedure is minimally invasive and can be conducted in the office, meaning that surgery or general anesthesia is not required. After testing the sample in a laboratory, it can be determined whether or not the lump is cancerous or benign, such as a fibroadenoma.
Stereotactic Core Biopsy (STCB)
Although a biopsy is necessary in order to determine whether or not a given lump is cancerous, sometimes a lump is too deep within the breast to be accurately located and sampled with a needle by hand. In these cases, WNY Breast Health uses a procedure known as stereotactic core biopsy, or STCB. This procedure is automated entirely by a computer, ensuring that accurate samples are taken from a suspicious lump, no matter where it is located within a patient’s breast. To begin, the patient lies prone on the ultrasound table, placing their breast through a hole in table. They are then elevated to the level of a television monitor in the room so that they may still observe the results of their mammogram as it is being performed. After locating the lump using the mammogram, the target area is selected using the computer and the anesthetic and biopsy needle are fit to the mechanical arm underneath the table. With the greatest accuracy possible, the anesthetic is administered and the sample is taken by the instrument using a vacuum powered hollow needle, insuring that the target area of the breast has been reached and correct results will be obtained. This allows for the testing of all detected breast lumps at WNY Breast Health, regardless of their location within the patient’s body. Following the sampling, a tissue marker may be inserted into the site of the biopsy in order to assist in finding the lump later during further testing or surgery.
If other tests such as ultrasound and mammography do not detect a lump, but a suspicious area is located using an MRI, then the radiologist may elect to take an MRI biopsy in order to sample the suspicious area when it can sill easily be found. This procedure works much like an STCB, in which MRI is used to locate the lump or unusual tissue area, and the instrument targets the area of the breast and takes a sample automatically, facilitating the sampling of very small or hard to find lumps. A hollow needle is used to penetrate the targeted tissue and extract a sample using a vacuum device. MRI uses radiowaves and magnets to obtain the images used for targeting the breast lump, meaning that there is no risk of exposure to excess radiation for the patient when undergoing the procedure.