Currently, there are a huge number of methods for the diagnosis of various diseases. To make a correct diagnosis is half the battle, because there is a chance of prescribing the correct treatment, and the patient will have chances for recovery. The female half of humanity often suffers from breast diseases. It is very important to recognize oncology at an early stage. That is why breast biopsy is prescribed, what it is, we will try to make out in more detail.
The concept of "biopsy"
The essence of this diagnostic method is to collect a small amount of tissue from the mammary gland for subsequent pathological analysis.
This analysis can most reliably confirm or refute the presence of a malignant tumor in the breast. A biopsy can also recognize suspicious cells.
This procedure is carried out directly in the doctor's office. Depending on the type of biopsy, it can be performed with or without painkillers.
Other research methods, such as mammography or ultrasound, unfortunately, can not give an exact answer about the malignancy of the formation, therefore, a breast biopsy is prescribed. What it is and what types of this study are, we analyze further.
For an accurate diagnosis using biopsy as the most accurate method of investigation. Depending on the technique of conducting it is of several types:
- Fine needle suction. It is carried out in the case when a tumor can be felt in the mammary gland. During the procedure, the patient may sit or lie on the couch. The biopsy site is treated with an antiseptic, then a thin needle is inserted, and some tissue or fluid is sucked into the syringe if there is a cyst.
- Stereotactic biopsy involves the taking of tissue from different places of the tumor. There are situations when the tumor can not be felt because of its deep location, then use the help of mammography or ultrasound.
- Thick needle biopsy. This method allows you to get a much larger part of the fabric, since the needle is equipped with a cutting tool. This gives you the opportunity to get the most accurate diagnosis.
- Stereotactic needle biopsy is used when it is impossible to probe a tumor. Mammographic images help determine the location of the needle.
- Incisional biopsy. In this case, a small piece of the tumor is cut off. This method is somewhat reminiscent of surgical intervention, so it is carried out using anesthesia.
- An excision biopsy is a miniature surgery. The surgeon removes only part of the neoplasm or completely. If cancer cells are detected, not only the tumor is removed, but also the adjacent lymph nodes.
What type of biopsy to choose, only the doctor decides after studying the tests and other studies.
Who is biopsy indicated
If you decide to visit a breast specialist, this does not mean that you will be assigned such a procedure. Most often, before a biopsy is prescribed, other studies are conducted that may give preliminary results.
Such methods include mammography and ultrasound, if after they appear suspicious, then a breast biopsy is indicated. Indications for this procedure can also be the following:
- appearance of nipple discharge, especially of bloody nature,
- palpation of tight education in the chest,
- there were changes in the nipple area, it can be peeling, discoloration, hollowness,
- the appearance of ulcers on the surface of the chest,
- mammography spots were spotted
- detection of suspicious sites in the chest during ultrasound.
If such pathologies are found, then the causes of their appearance can be established only with the help of a biopsy.
The importance of fine needle biopsy
This is a very informative analysis. Breast biopsy can detect not only oncological formations, but also benign changes, which include:
- papilloma intraductal,
- tumors, which represent the death of adipose tissue.
There are diseases for which a biopsy is prescribed, such as:
- cancer in the breast,
- chest cyst
After a biopsy of the breast, it will be possible to confirm or refute the dreaded diagnosis with 100% certainty. Do not be afraid of this procedure, especially since in 80% of cases the result is negative.
Biopsy is a diagnostic procedure, but it does have some preparation requirements so that it can be successfully performed. The doctor must warn the patient about some of the forbidden actions that are not recommended before the procedure:
- Alcohol should not be taken before a biopsy.
- Taking medications that interfere with blood clotting is also undesirable, as this may affect the result.
- If a woman is expecting a child, then an MRI biopsy is not performed.
- Magnetic resonance imaging for biopsy is prohibited if the patient has a pacemaker.
- Before the procedure, the woman should inform the doctor about allergic reactions to some drugs, if any.
It would be nice if a woman who was accompanied by such a procedure was accompanied by a close person who would not only be morally supportive, but would also help them get home if the woman feels unwell after the biopsy.
There is no need to go to the hospital for the biopsy procedure. This manipulation is performed in the mammologist or surgeon's office. If the patient is prescribed a breast biopsy, what is it and how to behave during the procedure, the doctor must explain.
A woman can lie on her back or on her side during the procedure, facing the doctor. When the study is conducted, it is advisable not to move and lie still. There are many types of biopsy, and on what to choose, the doctor decides depending on the specific situation.
Many people think that a breast biopsy is painful, but this procedure can also be performed under local anesthesia, especially since some types of this study involve the use of anesthesia.
After anesthesia and antiseptic treatment, the needle is inserted, with which a small amount of tissue or liquid is collected. After the procedure, there is no need to stitch up, it is enough to apply a cold compress and a pressure bandage. The amount of time to carry out such a procedure may vary depending on the complexity of the situation. After a biopsy, the doctor must warn that any physical activity is prohibited for the next day.
Breast needle biopsy
This type of study is prescribed in the case when a mammogram or ultrasound shows a volume in the breast, and it is difficult to make an accurate diagnosis. Puncture biopsy makes it possible to obtain tumor cells for further study.
Puncture biopsy is the most gentle diagnostic method. It resembles more intramuscular injection. Such a manipulation is carried out directly in the mammologist's office, and it consists of the following steps:
- The introduction of the needle in the tumor in the breast.
- Selection of tissue and fluid samples into the syringe.
- Removing the needle.
This method of fine-needle biopsy is often used in medical practice, because it is informative in terms of determining the good quality of education. The result of a breast biopsy will help determine further treatment tactics. The doctor can determine with accuracy the need for surgery.
When it is necessary to determine the type and degree of tumor development, then breast-trepan biopsy is applied. Its essence lies in excision of the body of the neoplasm or its part. The procedure is painful, so anesthesia is usually applied.
For the procedure, a special needle is used, consisting of a stem with a cutter and a long tube with a stylet, which is inserted into a previously made incision. A section of the cancerous tissue is cut, which allows you to get the most accurate result.
Thus obtained piece of tissue is subjected to further morphological study. Despite the high information content of this method of biopsy, they use it only in exceptional cases, since it presents some danger for the woman.
Post Biopsy Actions
If the procedure is carried out in the mammologist's office, then the woman after her graduation can go home. In addition to limiting physical activity, the rest of the life flows in the same direction. After performing a fine needle biopsy, bruising may occur.
To relieve your condition and reduce pain, you can take painkillers that do not contain acetylsalicylic acid.
If a breast biopsy was performed with surgery, patient reviews recommend better monitoring the condition of the sutures, preventing water from entering the incision and avoiding sudden movements. Be sure to consult with your doctor about seam care.
Getting biopsy results
The biopsy results will be known only in a few days, so you will have to visit the doctor again to find out. The conclusion that will come from the laboratory will necessarily contain the following information:
- tumor size,
- color and consistency of the samples taken,
- the location of tumors,
- the presence or absence of cancer cells.
If the results contain information about the presence of oncology, then the type of cancer and its susceptibility to hormonal drugs are given as additional information. Analyzing the results, the doctor together with the patient is determined with the most effective method of treatment.
Complications after biopsy
After any procedure and research undesirable consequences may occur. Possible complications associated with biopsy may be as follows:
- Swelling of the breast and hemorrhages.
- Infection and bleeding.
- The shape of the breast may change depending on the size of the removed tissue.
- Redness at the site of taking tissues.
- Increased body temperature.
If there are any suspicious manifestations, then this should be reported to the doctor. This may indicate the beginning of the infection process, then additional treatment will be required.
This is a biopsy of the mammary gland: what it is and why this procedure is necessary. The effectiveness of this method is really high, so you will have to resort to it for making a correct and accurate diagnosis.
Health for every person is the most important thing. Sometimes it is better to endure all sorts of inconveniences and pain, than to go through difficult and long-term treatment. Do not be afraid of biopsy, always hope for the best.
All women are interested in the question of how a biopsy is done, how much it hurts, and what the consequences may be after it.
In order to do a biopsy of the breast, you do not need to go to hospital, the whole operation is usually done on an outpatient basis under local anesthesia.
A woman lies back or sideways on a couch, raising her hand up. During the entire operation, you should lie quietly, not twitch, because the doctor must precisely introduce a needle to take the material of the breast tissue, and any sudden movement will injure the breast tissue and may even lead to the results of the tests being inaccurate.
Diagnosis of milky tumors can be carried out by various types of biopsy, such as:
- the procedure with the help of thin needles, the so-called aspiration,
- stereotactic breast biopsy,
- core biopsy
- procedure using MRI and vacuum apparatus
- open operation.
Tissue from the mammary gland by the method of aspiration or puncture taken using a thin long needle, and the whole procedure resembles the usual injection into the muscle.
Using a piston, the bipotates for analysis are sucked into the inside of the syringe and then transferred to histology.
In the case when the tumor can be palpated, the doctor does not use any additional equipment.
However, if the results of the ultrasound showed a tumor, but it is not palpable, then the doctor uses an ultrasound or MRI to take a tissue analysis from the right places.
This type of tumor tissue sampling for analysis is considered the most common due to the fact that its results are highly accurate, this method is virtually painless and is easily tolerated by patients.
However, puncture diagnosis of milky tumors is contraindicated in case of detection of recurrent breast cancer.
The stereotactic method of obtaining tumor tissues for analysis involves the collection of material from several tumor sites with a single biopsy needle.
Before taking the material for the histology of the stereotactic method, a woman must undergo a tumor mammogram, which will allow the doctor on the ultrasound machine to examine it from all sides in order to know exactly where to insert the needle.
This kind of diagnosis is carried out in the case when the tumor is not palpable, being somewhere deep in the gland.
Stereotactic biopsy is completely painless, after it almost never complications.
A trephine biopsy is similar to a conventional puncture diagnostic procedure, but it is performed with a thicker needle, more material is taken for analysis, and it represents not only fluids, but also more solid pieces of tumor tissue.
The trepan-procedure gives histologists the opportunity to absolutely accurately determine the nature of the biopsy specimens.
This operation is performed either before surgical removal of the tumor, or before radiation therapy.
They do it quite rarely, because the trephine biopsy, due to the large excision of the mammary gland, represents a certain threat to the woman. Perform trephine surgery under local or general anesthesia.
A core biopsy is a type of diagnosis carried out not by a thin needle, but by a thick needle, which, when inserted, takes a large cylinder not only for the analysis, but also for the tissue of a milky tumor.
It is made with the help of a special biopsy gun, which is pushed inside the gland, “shoots” into the tumor, takes its tissues for analysis and comes back.
Since tissue samples for this type of diagnostic study need at least six, the procedure is repeated several times.
Vacuum diagnostics is considered one of the most effective, painless, and guaranteeing accurate data analysis.
This procedure is carried out using an ultrasound machine, through which the doctor carries out a visual observation of where the needle is inserted for the material intake.
When a needle reaches the tumor tissues, a rotational movement begins, a vacuum is created, thanks to which the tumor tissues stick to the biopsy device.
In this way, many pieces of tissue can be obtained for analysis and even a small tumor can be removed, provided that it is benign. In the case of malignant milky-malignant tumors, vacuum biopsy is prohibited.
Due to the variety of diagnostic methods, biopsy is sometimes performed using magnetic resonance apparatus.
In this case, the diagnosis is slightly different than in previous cases.
A woman, stripped to the waist, should lay her stomach down, placing the mammary glands in special holes on the table.
After that, the doctor, focusing on the readings of the device, inserts a biopsy needle into the mammary gland and carries out tissue sampling from the tumor.
Doctors prefer this method of diagnosis if they cannot palpate an existing neoplasm.
Surgical intervention, or open biopsy, is done excisionally or incisionally.
The latter option involves the removal of a small area of the neoplasm, whereas the excisional method removes the entire tumor.
This kind of procedure is considered a full-fledged operation, therefore it is performed in a hospital under general anesthesia.
After excisional surgery, the patient has a scar, unlike previous diagnostic methods, because the incision is large.
May even change the shape of the breast. In this case, the whole tumor is given to histology so that the polymorphic analysis shows whether there are atypical cells in it or not.
Interpretation of analyzes
The results of the histological examination of the tumor material will be ready in about 7-10 days.
The conclusion of histology describes the tumor in the following ways:
- tumor volume
- окраска и плотность материала, взятого на изучения,
- место дислокации в молочной железе,
- наличие или отсутствие атипичных клеток.
Depending on the histology description of the tumor cells, the results of the polymorphic analysis may be as follows:
- normal, or normal: that is, the sample sent for analysis consisted of completely healthy cells,
- incomplete if the sample was too small
- noncancerous when a cluster of cells is not a sign of the presence of a tumor. This condition of the breast occurs with mastitis,
- benign if there is a tumor, but no atypical cells were found in it,
- malignant, when the analysis found the presence of atypical cells in the tumor.
Based on the results of histology, the doctor prescribes treatment.
As with any invasive procedure, there may be minor complications after a biopsy.
However, in the event of a sharp rise in temperature and incessant bleeding from the incision area, you should immediately consult a doctor, because an infection may have entered the wound.
Indications for the appointment of the procedure
Pain in the mammary gland, compaction and redness, which can be seen at home during the examination, become the reason for going to the breast specialist.
Reasons for a biopsy:
- chest seals are felt,
- the pictures show various spots,
- there were nipple discharge, including bloody,
- ulcers on the epithelium of the chest,
- nipple retraction, pain around the nipple,
- various peeling, swelling of the breast,
- no other way to diagnose a disease
- suspected oncological disease.
Does it hurt when performing a breast biopsy?
Regardless of the method of taking biomaterial, the study is rather unpleasant. Depending on the type of biopsy, the doctor will do the anesthesia.
Soreness of biopsy types:
- Needle method. According to the patient reviews, the needle biopsy method is the most painless. It is performed without anesthesia (if the patient is willing to endure an injection), or an anesthetic gel is applied to the skin where the needle will be inserted.
- Trepan biopsy. The procedure is similar to the needle method, only samples are obtained using a special gun into which a biopsy needle is inserted. It is rather voluminous, which makes it possible to obtain a whole section of tissue for analysis. Before the introduction of the needle is a small incision of the breast. The intervention is performed under local anesthesia.
- Surgical method. Operation. It is carried out under local anesthesia, and if the patient is very worried and worried, the doctor will suggest that you do a full anesthesia to avoid an increase in pressure and other negative consequences. After surgery, there may be a slight pain from the violation of the integrity of the tissue.
How is breast biopsy done?
The procedure takes place under sterile conditions. The doctor must be in disposable gloves.
The patient may sit, lie on his back or on his stomach. The chest can be in a natural position or be clamped in a special device. In most cases, the woman is on the couch facing the doctor.
The procedure is as follows:
- In the puncture site, the skin is treated with antiseptic.
- After that an anesthetic gel is applied on the chest, or local anesthesia is done. In certain cases, general anesthesia may be given at the request of the patient.
- Next, the needle is inserted, during this in no case can not move.
- The process of cell collection occurs quickly and is monitored by a specialist visually, using an ultrasound machine, mammography or radiological control.
- After completing the procedure, the doctor treats the injection site, stops bleeding with a pressure bandage or a compress with ice. It should be kept no more than 10 minutes, then take a break and reapply the cold to the injection site.
- When the blood is stopped and the patient's condition stabilizes, a bandage is applied, the use of compression underwear is possible.
- Another half hour the woman is in the hospital, after which she can go home.
The fabric obtained during the analysis, passes a number of studies. Samples cut into thin layers, the size of 5 * 10 * 5 millimeters. If the fabric is contaminated, then it is washed in a saline solution, after processing the biomaterial is poured with 10% formaldehyde solution.
Having achieved the purity of the material proceed to his study. It is carried out under a microscope or binocular magnifying glass. The specialist works on a variety of symptoms that are markers for the diagnosis of a neoplasm.
After the procedure
Recommendations on personal hygiene are mandatory: after the procedure, the chest should not be wetted for 48 hours, it is necessary to exclude visiting the bath and sauna. Especially you should avoid any physical exertion on the hands and pectoral muscle. In case of deterioration of the condition, the patient should immediately contact the attending physician.
What reveals a biopsy and its types
The object is examined for:
- nodules, vitreous and psammous bodies,
- areas of necrosis and calcination,
- sealing boundaries
- ironiness, graininess, homogeneity of the glandular tissue,
- cell shape and size.
There are the following types of breast biopsy:
- fine needle suction,
- needle puncture,
- trepan biopsy
- vacuum aspiration.
The most gentle method for the study of non-palpable tumors found in the mammary glands. Allows you to recognize both a cyst and a tumor. Glandular tissue or fluid is collected from the tumor into the syringe. The disadvantage of the procedure - you can get only the cells of the tumor. For the analysis of cancer is also needed tissue.
In addition to cancer, a fine-needle biopsy diagnoses benign changes:
- tumors consisting of dead fat tissue
- papilloma intraductal,
- cystic formations in the breast,
It is carried out in the case when compaction is felt by fingers, but the boundaries of the investigated area are not entirely clear and more material is required for verification. It is performed using a large-diameter biopsy needle with a special cutting tip. After the anesthetic, the specialist makes a small incision on the chest, about 0.5-0.7 centimeters, to insert the equipment. This method is used to diagnose a breast cyst.
Vacuum aspiration biopsy (PSA) is an advanced method for detecting benign and oncological diseases of the breast. The examined breast is gently fixed, anesthetized, after which the Encor vacuum gun is installed. Samples of tissue under pressure are raised in a special container for collecting tests. It is possible to get from 8 to 10 samples from different areas, while the needle itself does not reach from the chest, it only changes the angle of inclination.
Aspiration takes 30 minutes, is performed under local anesthesia. After the intervention, there is a small red dot, which passes in two or three weeks. Breast shape after PSA does not change.
Vacuum is successfully used for:
- removal of cysts,
- flowing papillomas,
- fibroadenomas of the mammary gland.
The modern method allows you to enter a robotic needle into the incision with a diameter of up to 5 millimeters, minimizing blood loss and without disturbing the integrity of the milky ducts. Alternative treatment methods in the future lead to the formation of mastitis during pregnancy, the vacuum eliminates these consequences.
Biopsy controlled by mammography
This type of biopsy is considered sighting. The essence of the procedure is that the path of the biopsy needle is tracked with the help of a mammograph. It is called a stereotactic breast biopsy.
This procedure is prescribed if the tumor is located very deep, or there are foci of microcalcifications after the performed operations. Before the procedure, the patient undergoes an X-ray examination in different planes, allowing to choose the best path to the biopsy object.
Also differs in carrying technology. A woman lays down on a special couch with openings for the chest, a compression apparatus and sensors of the mammograph are fixed on the mammary gland. The procedure is similar to TAB, depending on the indications use needles of different diameters. In terms of diagnostic accuracy, it is not inferior to the surgical method, but less traumatic. After the intervention, there are no scars on the chest, the shape does not change.
This method is similar to the conduct of a biopsy under the control of a mammogram, only the movement of the needle is monitored using an ultrasound machine. During the procedure, the patient is in a classic position, lying on his back or side. The specialist conducts diagnosis, notes the location of the tumor, the puncture site of the tissue. The entire procedure is on the chest ultrasound sensor. The monitor displays the movement of the biopsy needle to the surface of the tumor.
It is worth remembering that the use of ultrasound, MTR and mammography in biopsy is accompanied by a certain amount of radiation and has a number of contraindications, including pregnancy. The safest procedure is considered to be under the control of ultrasound.
In essence, this method is a complete operation. This procedure has not only diagnostic, but also therapeutic functions. It is performed under general anesthesia. During such a biopsy, the doctor completely removes the neoplasm, and if there is evidence, then the organ where it is located. Tumor tissues are sent to a study that allows you to find out the type of tumor, its possible consequences for the body.
The procedure is characterized by high accuracy, but has a high degree of danger to the patient. After the surgery, breast correction is necessary. Special quotas are allocated for these purposes, which a woman can use. If you can get a referral, then plastic surgery is free.
This is also a surgical procedure, only more gentle. During surgery, the doctor removes only part of the tumor, or part of the mammary gland, where the tumor is located. As in the case of an excisional biopsy, subsequent breast correction may be required.
This type of research is carried out if:
- less traumatic biopsy variants did not give an accurate answer, the suspicion of a malignant tumor remained,
- identification of the immunohistochemical nature of malignant tumors,
- before radiation treatment.
Preparation for breast biopsy
No special preparation for the biopsy procedure is required. The doctor will give detailed instructions on what to do before taking the analysis.
Before a biopsy, you should inform your doctor about allergic reactions and chronic diseases.
- refuse aspirin and blood clotting drugs,
- do not use antiperspirants,
- remove jewelry
- give up alcohol.
Before proceeding with a biopsy, an ultrasound scan is performed. Ultrasound examination shows the location of the tumor.
Consequences of the diagnosis
Doctors note that a neoplasm after a biopsy does not change its structure in any way, it does not begin to grow more actively. The consequences can only be in the form of complications, which are a marker of the tolerability of the procedure.
They may occur at the stage of tissue healing:
- breast swelling,
- bruises and bruises,
- burning effect
- discharge from the puncture site,
- bleeding and infectious infections.
Due to excessive excitement, such unpleasant consequences can occur as:
The doctor of the Moscow Doctor Clinic talks about the features of such a procedure as a biopsy.
Deciphering Breast Biopsy Results
How long will it take to wait for the results of the analysis depends on:
- the complexity of the analysis
- established regulatory deadlines.
As a rule, the study takes from one to one and a half weeks. The doctor will decipher the medical document, he will also prescribe additional tests if necessary.
The lab report will display:
- consistency and color spectrum of the samples taken,
- information about the estimated size of the tumor and its location,
- malignancy of cells of the studied material.
If the cells have several nuclei, they are large in size, have a high content of chromatin, then we are talking about tumor tissues.
The morphological and histological conclusion of the biopsy will indicate which cells were detected:
- Malignant. The patient is sent for additional studies to determine the type of cancer.
- Benign. There is a tumor, but it does not carry information about cancer cells. Other inflammatory processes and neoplasms.
- Optimal or normal. When all studied markers are within normal limits, or are completely absent.
- Unable to analyze. This is due to poor quality material or its insufficient quantity.
In the video, Dr. Levchenko, a practicing mammologist, describes in detail how long it takes and how the procedure for taking a biomaterial from the breast takes.
Who is appointed
A biopsy is a medical procedure during which cell samples are taken from the chest for examination. Often the purpose of this analysis is to determine the nature of the tumor. A biopsy is performed when other research methods have failed.
The appointment of a biopsy procedure is recommended only in certain cases. Before it is carried out for diagnostic purposes, mammography or ultrasound is already done. Establish the presence of seals in the breast, their number, size, location. Further use of a biopsy may reveal a cyst, fibroadenoma, or oncological tissue degeneration.
Indications for the appointment of a biopsy is:
- changing the shape and position of the nipples, forming crusts on them, drawing in, changing color,
- seal detection
- discharge of fluid from the nipples, especially with blood, pus,
- changing the shape, size of the breast,
- some diseases - mastitis, cysts, mastopathy, fibroadenoma,
- the appearance of redness on the skin, other violations of the skin.
If a multifocal tumor is found, a breast biopsy will be performed from two seals.
Important psychological side of the procedure. The doctor should tell the woman about the purpose of the study, the need for it. Lack of information engenders fear and depression, which only exacerbates the disease. According to medical statistics, in 80% of women a biopsy is negative, that is, oncology is not confirmed.
There are restrictions for this manipulation. It is impossible to undergo a biopsy for such diseases and conditions as:
- pregnancy, breastfeeding,
- the presence of a pacemaker
- individual intolerance to anesthetics,
- increased body temperature
- increased seal size (more than 5 mm),
- acute infectious diseases
- severe pain in the back, neck, shoulders of various origins,
- there are impaired blood clotting.
Contraindication is also the inability of a woman to remain immobile during a biopsy. Survey takes about 1 hour, at this time you need to lie still.
Varieties of biopsy techniques
When choosing a biopsy method, the specialist will take into account the results of other examinations, symptoms. Needle and surgical types of biopsy differ depending on the method of tissue sampling. Needle is performed by a variety of tools. Their description is presented in the table.
Name of needle examination methods
It is used in the examination of entities that are only palpable. A thin needle with a syringe is inserted into the intended area of the lesion. Fabric samples are drawn in. This percutaneous method can detect a cyst with fluid, a tumor.
In this examination, thick needles with cutting devices are used. A special device allows you to automatically sink into the tumor and return. This helps to select a large amount of biomaterial, to obtain accurate results.
X-rays are used to guide the needle. A mammogram is performed to accurately determine the location of the seal. Next, an incision of up to 7 mm is made, through which several tissue samples are taken. It is used to examine seals located deep. Need anesthesia.
Produced by the device - a pistol with a needle. From the seal is taken a column of material the height of the largest tumor. Anesthesia is not required. The method does not leave hematomas on the skin, no need to make stitches.
It is used under the control of ultrasound, with local anesthesia. It can be used to remove small tumors.
Surgical biopsy techniques require mandatory anesthesia and suturing. In this case, an incisional method is used when part of the diseased organ is removed in the study. Excisional method involves excision of the tumor, only then the selection of biological tissue samples.
Surgical methods include trepan-research. It is produced when the surgeon opens the mammary gland, providing access to the tumor. Tissue sampling and removal of cystic seals may be performed. Painful manipulations, therefore, require general anesthesia.
Preparation before carrying out
In order for a biopsy to give an accurate result, and the treatment is a positive effect, you need to properly prepare for it. The patient should inform the specialist about the presence of chronic diseases, the constant intake of any drugs. Чтобы избежать осложнений, нужно выполнять простые правила подготовки:
- 3 days before the examination should stop taking anticoagulants (blood thinners).
- On the eve do not drink alcoholic beverages.
- On the day of the biopsy, do not smoke.
- Warn the doctor about contraindications - the presence of a pacemaker, possible pregnancy, allergic reactions to medications.
- To come to the procedure with the attendants who will wait, and then they will go home.
On the day of the biopsy procedure, it is recommended to put on light clothing, remove glasses, jewelry, dentures, do not use deodorants, cosmetics. If the test is a concern, it is better to take a sedative before the procedure. The patient's calm state will enable the doctor to more precisely carry out the manipulation.
How is breast biopsy performed?
Medical manipulation is performed under sterile conditions. Before the start of the manipulation, a blood clotting test is taken from the patient. The patient will lie on the stomach or back, depending on the type of research method. The mammary gland will be in the usual position or clamped in a special device.
The puncture site is treated with an antiseptic. To avoid pain, put a special gel. In some cases, anesthesia is used.
Then the needle is inserted into the seal. At this time it is strictly forbidden to move. How long it will last depends on many circumstances, and only a doctor can tell it. On average, cell sampling passes quickly; according to reviews, it cannot be said that it is very unpleasant.
At the conclusion of the manipulation, the puncture site is processed, with bleeding, a cold compress is applied. You can hold it for 10 minutes, then take a break. So you can avoid the inflammatory process in the chest.
After stopping the blood, normalizing the patient's condition, bandage, send it home. The presence in the hospital is necessary if the mammary gland starts to inflame.
Interpretation of the results
The study of tissue in the laboratory takes time, in some cases up to several days. The duration of preparation depends on the complexity of the studied samples. Experts conduct a macroscopic analysis, give an opinion on the nature of the seal. The decoding will provide data on the size of the seal, location, detection of cancer tissue changes.
It is accepted to decipher the results by groups:
- normal - no cancer cells,
- incomplete - indicators differ from the norm, re-check is required,
- noncancerous - there are abnormal cells, other diseases are diagnosed,
- malignant - atypical cells detected, localization and size determined
- benign - cells with chaotic division are identified, but they differ from cancer cells.
- According to the results of decoding determine further treatment.
The consequences after the procedure are minimal. Side effects are rare. The doctor may prescribe the procedure if the woman herself comes with a request for an examination if there is a suspicion of a tightness in the chest.
Do a biopsy of the breast need when seals of unknown origin. It will save from serious problems.
The cost depends on the type of biopsy. The procedure can not be cheap, since complex equipment is involved in the manipulation. In Moscow, the average price is 5,000 rubles. The main thing is to make this procedure in time. The timing of the biopsy is important for further success in treatment.
Indications and contraindications
The biopsy procedure is prescribed only by a physician when it detects atypical clarified or darkened areas of the mammary gland and unusual seals for it.
A woman herself should turn to specialists if she has:
- Palpable breasts are felt,
- There was a causeless peeling on the skin of the breast and other incomprehensible flaws, including peeling or crusts on the nipple and around it,
- There are secretions from the nipples bloody, slimy, and any other character
- The appearance of ulcerations on the chest.
Milky-iron biopsy usually has no contraindications. However, the procedure cannot be performed for women in position or with established biostimulants.
Various types of biopsy diagnostics, such as vacuum and stereotactic, fine-needle aspiration and surgical, trephine biopsy and core biopsy, MRI biopsy, etc., are used in the diagnosis of milk-ferrous tumors.
In each clinical case, the method of biopsy is selected individually, taking into account the parameters and localization of the tumor process, as well as the preferences of the patient.
Fine-needle aspiration puncture biopsy of the mammary gland is a gentle diagnostic procedure and is prescribed if, after an ultrasound and mammography examination, a volume tumor has been discovered, with regard to the morphology of which the doctor has doubts.
The TAPB technique is now actively used in practice due to its high information content.
According to the results of the biopsy, examining the fluid or cellular samples from the tumor, the doctors decide on the operation.
A puncture is made with a thin hollow needle, after which the biomaterial is collected to determine its nature. The biomaterial is sucked in by a piston of a special syringe, and then examined under a microscope. Moreover, the needle through which the biopsy is obtained is much thinner in diameter than the injection needle.
If a tumor can be felt, the doctor directs the needle blindly, although control such as x-rays, ultrasound or magnetic resonance diagnostics is more often used. The aspiration needle is very thin, so pain relief with this method is not required. An anesthesia injection will deliver more than the biopsy procedure itself.
In the process of carrying out the stereotactic technique, a computer and an x-ray machine are used, which help to clearly analyze milk-iron images and clarify the specific place of needle insertion. So it will be possible to accurately get directly into a suspicious entity.
This technique is often used to identify non-visualized and non-palpable formations by ultrasound, as well as the smallest calcium deposits - microcalcifications.
This biopsy technique is performed using specialized systems like ATEC or Mammoth.
The breast gland is anesthetized, then an incision is made in it, into which the cutting abdominal needle is found.
Under X-ray, ultrasound or magnetic resonance control, it is sent to the tumor tissues, where a cylindrical piece of education is sucked into the needle under vacuum action.
Since the needle is equipped with a knife, it cuts off the retracted piece of other tissues.
In this way, several biopsy samples are taken from different places of the tumor through just one hole in the chest.
The advantage of this method, experts believe a much larger number of biomaterial samples obtained simultaneously than, for example, during the puncture procedure.
Vacuum biopsy is performed on an outpatient basis. Since the incision on the chest is very small, there are no scars left after such a study.
Sometimes the procedure for obtaining a biopsy is carried out under the control of a magnetic resonance tomograph.
The woman is placed on a special table down with her stomach, while the breasts are placed in specially designed holes. Then the specialist proceeds to scanning, with the help of which the localization of the formation and the direction of the needle are precisely determined.
MRI biopsy is most preferable for women with highly suspicious tumors who are not visualized using other diagnostic methods and cannot be palpated.
This method of obtaining biological material is also called open and involves carrying out a full surgical intervention, during which the surgeon receives a biopsy for further histology.
An open biopsy is performed by an excision or excision method. In the first case, a small area of education is removed, which is sufficient for research and diagnosis. In the second case, the tumor is completely removed.
A surgical biopsy is performed in a hospital using general or local anesthesia. Such a procedure is considered technically more complex than trephine biopsy or puncture biopsy. After healing, a characteristic scar remains, and if an excisional biopsy was performed, in which most of the tissue was removed, the shape of the breast may also change.
After the procedure, women often have severe swelling of the breast, pronounced bruising, which disappear on their own after postoperative rehabilitation.
Biopsy sampling is carried out using specialized needles of various thickness. Core biopsy is performed using a large-diameter needle.
Such a biopsy needle can take a tissue column not only from the skin, but also from the inside of a particular organ, which in this case is the mammary gland.
A core biopsy is performed through the use of a specialized device (such as a pistol), which ensures the smooth movement of the needle inside the tumor, the collection of material and the return of the needle.
Such biopsy sampling can occur simultaneously several times (3-6), which is very convenient, since it provides a large amount of biomaterial for histological analysis.
How to perform the analysis of the breast?
Biopsy is considered by doctors as the most gentle method for diagnosing milk-ferrous formations and seals, which makes it possible to determine the diagnosis with maximum accuracy.
There are many methods of biopsy, each of which has its own advantages and indications. Take the material on an outpatient basis using anesthetic drugs.
The preferred time for the procedure is the interval from the 7th to the 14th day of the cycle. Special training is not necessary, most importantly, meet several requirements.
- The woman is conveniently placed on the couch.
- Anesthesia is injected and an ultrasound transducer is placed on the chest.
- Ultrasound helps to determine the exact location of the abnormal tissue into which the needle is inserted, and the biopsy is collected. All manipulations are displayed on the monitor.
- In moments when a biopsy needle is inserted, a woman may feel a slight sensation of painful pressure.
- After receiving the biomaterial, the doctor applies the measures necessary to stop the bleeding and applies a bandage.
After that, the woman is allowed to go home, where she is not recommended to engage in active physical work for 24 hours.
With a tumor
If a woman finds a palpable seal in her chest, then she needs to immediately contact a breast specialist. If the doctor assumes the presence of a tumor, then the most appropriate solution would be a biopsy.
This method of diagnosis is considered the most informative in terms of determining the nature of the resulting tumor.
Before a biopsy, a woman usually undergoes a diagnosis, including:
- Ultrasound procedure,
- Computed tomography
- Analysis for the detection of tumor markers,
- Palpation, etc.
The choice of the method by which the biopsy will be obtained depends on a variety of individual factors.
TAPB is the simplest and preferred, however, it is not always sufficiently informative. Therefore, it is better to stay on the core or trepan biopsy. Such procedures not only help determine the morphology of education, but also to study the receptors.
For small tumors, the stereotactic or fine-needle biopsy method is the best option, and if they do not provide adequate information about education, a surgical biopsy may be needed.
When cystic milky-ferrous formations, which are sacs filled with contents, are detected, biopsy diagnostics is often used.
Cysts are palpable when examined by a doctor and do not cause painful sensations during palpation.
Although cysts for the most part are benign tumors, they are still a sign of cystic-fibrous type of mastopathy, which is considered by breast specialists as a precancerous background pathology.
Therefore, timely detection and treatment are important in this situation, even vital.
Biopsy in a similar clinical situation is an important diagnostic element that helps eliminate or detect atypical, malignant cellular structures. In the process of conducting a biopsy, the patient takes not only a piece of cystic membrane, but also its contents.
Biopsy is usually supplemented by ultrasound, MRI, pneumocystography, mammography, etc. To obtain a biopsy, methods of trepan biopsy, core biopsy, etc. are used.
A biopsy gun is used to obtain a tissue biopsy, and cellular material is obtained using a fine needle. Puncture biopsy in this situation acts as a therapeutic measure, because in the process of its implementation a complete removal of cystic contents is performed.
As a result, the walls of the formation stick together and it disappears. Trephine biopsy in cystic lacteous formations is appointed only when there is a suspicion of the presence of a malignant tumor or cystoma.
Fibroadenomas are considered the most common milky-ferrous formations of a benign character. Outwardly, these tumors have a spherical shape and are formed from fibrous cellular structures.
Such formations are most characteristic of patients younger than 30. Fibroadenomas do not grow more than 3 cm, although sometimes they can grow up to 5 cm.
Such procedures as ultrasound, mammography and biopsy help to confirm the diagnosis, the latter being the only diagnostic technique that allows determining the type and nature of education as accurately as possible.
If ultrasound and mammography accurately showed that there is fibroadenoma, then patients under the age of 25 need no biopsy.
Older women need a biopsy to determine the composition of cellular structures in order to promptly prevent the development of milky ferrous cancer.
According to statistics, about 10% of leaf-shaped fibroadenes eventually degenerate into sarcoma. Therefore, biopsy can be extremely helpful in preventing breast cancer.
No patient is insured against a malignant breast tumor, therefore women need to conduct self-examination monthly.
If the slightest changes in a breast are found, then it is necessary to be surveyed.
If the etiology and nature of the formation in the breast is unclear, then a biopsy examination is recommended.
In the process of biopsy of the milk-ferrous tissues, it is possible to obtain a tumor sample, due to which cytologists can accurately determine its nature.
Fine-needle or thick-needle aspiration is used to obtain a biopsy. Sometimes a surgical biopsy is performed, which is usually combined with operative excision of a milky ferrous mass.
The specific biopsy technique that will be most appropriate for breast cancer is selected based on factors such as size and location, the number of cancers and the presence of metastases. The biopsy at recurrence is important, then the procedure is carried out in stereotactic or fine-needle way.
Breast biopsy results: decoding
The results of the diagnosis, the patient receives after 10 days. Results are classified into several groups:
- Normal - when the diagnostics showed that the indicators are within the normal range,
- Incomplete - if in the course of the procedure not enough biopsy was obtained, or when obtaining ambiguous results. In such a situation, it is necessary to re-analyze
- Non-cancer - when atypical cellular structures or atypical non-cancerous elements like inflammatory foci, mastitis or cysts are detected,
- Benign - if a benign tumor is detected,
- Malignant - when the biopsy results showed the presence of cancer cells.
Recommendations after analysis
In the first day or two after the procedure you can not return to the same physical activity. To eliminate puffiness and hemorrhages, as well as minor discomfort in the puncture area, it is recommended to put an ice pack on the chest.
If a surgical biopsy was performed, some care for the sutures will be needed. Before their removal it is impossible to wet them, try to avoid sharp body turns, jerks with hands and other sudden movements.
She underwent a biopsy 7 years ago, when a lump of unknown origin was found in the chest. She was terribly afraid that they would find cancer, the biopsy procedure, which she didn’t know anything about, added fear. They put me on a couch, and so as not to twitch, the nurse held her shoulders. Just awful. It was painful, I will not say that it is just unbearable, but not fatal. Give birth harder. Потом неделю ждала результатов, ночами не спала, но все обошлось. Шишка оказалась доброкачественной.
Во время УЗИ в груди было обнаружено небольшое уплотнение. The doctor could not determine the nature of the tumor, so he sent it to an oncologist who prescribed a biopsy. There is pain in the process, but it is dull, you can suffer. The doctor inserts a syringe and using a pumping operation, picks up a biomaterial. The results did not show anything bad. The doctor watched the growth of adenoma and a half years. But it so happened that at the next ultrasound scan of my doctor I replaced another one, who doubted the good quality of education. Conducted a second biopsy. The needle was injected 7 times, everyone could not get there - the tumor was too mobile. As a result, the tumor was removed and sent for histology. It turned out to be still benign. But I suffered terribly with these biopsies.
How much is?
A biopsy of milk-ferrous formations in Moscow clinics costs about 500-12350 rubles. The total amount depends on the range of additional services, type of anesthesia and control, biopsy method and other factors.
Video on the methodological issues of signaling lymph node biopsy in patients with breast cancer:
Vacuum and puncture breast biopsy
Any puncture of the mammary gland should not be carried out as a routine examination and should be performed only before the start of treatment.
Techniques for taking cells for morphological study using invasive needles have high confidence (88%), accessibility, unlimited repetition and simplicity. Breast puncture and its results are very important in cases of suspected tuberculosis of the gland, galactasase, the presence of a cyst or galactocele. These techniques perfectly help the doctor to distinguish a cyst from a tumor, mastitis from an acute form of cancer. Breast biopsy also refers to the most optimal method for treating a breast cyst, the size of which exceeded 1.5 cm - after puncture and suction of fluid, the walls of the neoplasm are glued together by themselves.
In order to avoid consequences, in cases where there is a suspicion of a skirous tumor, hyallinous fibroadenoma or a tissue sample will be taken from deep-seated small tumors, the oncologist performing the manipulation must have experience and certain skills.
Depending on the goals pursued, for the procedure can be used different techniques:
- Vacuum or aspiration. Tissue aspiration is the “suction” of the desired fragments, by creating reduced pressure. The cells are sucked through the needle into a special device. Aspiration biopsy, which is under the control of ultrasound, as well as features of the device, allowing to change its position inside the gland, make it possible to take up to 10 samples in one puncture.
- Puncture. This technique uses a manual or automatic syringe. The disadvantages include the fact that during the puncture you can take only one sample and to detail the extensive tumor will require from 5 to 7 procedures.
Depending on the thickness of the needle, a breast biopsy (vacuum or puncture) can be performed in one of three ways. In the case of vacuum diagnostics, an “aspiration” will be added to the title. All diameters of the needles can do without stitches.
- Fine needle biopsy. Basically, a fine needle puncture of the breast is performed aspiration (vacuum). This is a simple and painless technique. Biopsy sampling with a fine needle is suitable for taking liquids. The puncture is performed quickly and does not hurt. The puncture site is pre-disinfected and anesthetized (local). The skin of the breast is injured minimally. Fine-needle manipulation generally takes about 20 minutes and is performed under sterile conditions. An additional guarantee of security is provided by preliminary ultrasound and mammography.
- Thick needle biopsy. Such a study is appointed when there is a suspicion of a cyst or the boundaries of the tumor are blurry, as well as when a large amount of material is needed. A thick needle is used to collect tissue samples. For pain relief, an injection of a local analgesic is chosen. As a rule, a biopsy of the mammary gland with a thick needle is performed not by a vacuum method, but by taking a regular puncture.
- Stereotactic biopsy. With the help of this manipulation, histological material (biopsy) is removed from several areas using a single (thin, thick) needle. Such a puncture of the mammary gland is carried out only after preliminary preparation - performing several X-rays taken at different angles. A mammograph and 2-3 ultrasound machines are needed for control. Stereotactic breast biopsy is designed to study tumors of deep localization.
Trepan breast biopsy
In some cases, before starting radiation therapy, more in-depth cytological examination is necessary. Trephine biopsy has a high reliability of results - 91%. To perform the procedure, an automatic cutting needle with a spring mechanism and a special container is used.
Sometimes, a trephine biopsy is performed directly during a surgical operation that is performed under general anesthesia:
- taking tissue samples, for subsequent postoperative diagnosis - sectoral resection,
- use of trepan instrumentation and eletrocoagulator for the treatment of large cysts - burning walls without epithelial lining.
During surgery, general or local, and during diagnostic manipulation - local anesthesia is used. Abuse of trephine biopsy is unsafe and must be justified.
Before and after diagnostic biopsy
A biopsy of the mammary gland for diagnostic purposes does not require special preparation and consists in abstaining from taking a few (check with the doctor) medications that may affect the test results, aspirin and others that thin the blood or reduce its clotting, drugs. On the day of the procedure it is prohibited to use hygienic and perfume lotions and deodorants.
After the procedure, it is desirable to relax during the day. Acetaminophen (Tylenol®) is recommended and further abstinence from aspirin and anticoagulants is recommended. It is forbidden to visit the swimming pool, sauna and bathing for 7 days. Water procedures - warm washings and showers are allowed after 24 hours. Ice can be applied to the puncture site only for 3 hours after the procedure and in the mode - 20 minutes of an ice compress: 10 minutes pause. A few days, the puncture site should be lubricated with antibiotic ointment and protected with a sterile dressing.