Did you know that, next to skin cancer, breast cancer is the most commonly diagnosed cancer among women in America? This news often takes people by surprise, especially if they or someone they know receives such a diagnosis.
The good news is that treatment options have come a long way in the past few decades - now, if detected early, the five-year survival rate for women with stage 0 or stage I breast cancer is almost 100 percent. This underscores the need for annual breast exams and follow-up diagnostic screenings in case any suspicious masses are found.
If your doctor recommends a breast biopsy, you may be wondering what this means for you. At Memorial Hermann, we believe the greatest threat to patient health is a lack of education, which is why we've provided the following information about breast biopsies so you;ll be able to find the course of treatment that works best for you.
Biopsies involve the removal of a piece of bodily tissue in order to determine the presence or nature of a disease. This tissue is either examined chemically or (more commonly) under a microscope by a licensed pathologist in order to provide a diagnosis, setting the stage for treatment.
Biopsy samples can be taken from many different parts of the body, including bone marrow, lungs, the liver, or from the breast. During a breast biopsy, a doctor will remove tissue from a suspicious area to be tested for the presence of cancer cells. A breast biopsy is the only sure way to diagnose breast cancer.
There are actually three different methods for performing a breast biopsy. One will be chosen for you based on specific criteria:
Fine-needle aspiration (FNA) places a thin needle through the skin and into the suspicious area to withdraw (or aspirate) cells for examination. This needle is actually thinner than those used for traditional blood tests.
Sometimes called a Lymph Node Breast Biopsy, this procedure may be used on lymph nodes (located in your armpit area) or lumps found during routine breast exams to see if the lump is solid or a fluid-filled cyst. If the lump is a cyst, it will normally go away after the fluid is removed.
Similar to a Fine-needle aspiration, a core-needle biopsy inserts a special type of needle through the skin and into the lump or area of concern to remove a sample of tissue about the size of the tip of a pencil. A core-needle biopsy can also be done using a suction unit that gently removes a larger sample of tissue.
What separates this technique from other biopsies is the use of ultrasound imaging. A radiologist will perform an ultrasound exam first to find the exact location of the tissue to be collected, and then use real-time imaging from the ultrasound to guide a needle with pinpoint accuracy to remove the tissue sample.
Much like an ultrasound-guided core needle biopsy, a stereotactic - or X-ray guided - breast biopsy uses digital imaging technology or Tomosynthesis imaging technology for enhanced precision when targeting and removing tissue samples. Stereotactic breast biopsy requires the use of very specialized equipment.
Stereotactic breast biopsies leave little to no scarring and are often more effective at evaluating calcium deposits or tiny masses that are not visible on ultrasound.
If your annual screening mammogram, ultrasound, or physical breast exam detects a lump of suspicious mass, a breast biopsy will need to be performed in order to determine if it is cancerous (malignant) or non-cancerous (benign).
As women get older, sometimes tiny bits of calcium build up in their breasts. These are called calcifications. They are found in about half of all women over the age of 50, and are not necessarily dangerous by themselves. Calcifications will show up as bright white spots on a diagnostic mammogram, almost like little pieces of chalk dust.
Though they are usually benign, calcifications may be a sign of breast cancer if arranged in certain patterns, like a tight cluster or a line. A breast biopsy will need to be performed on the area in order to give an accurate diagnosis.
Don't panic! Just because you need a breast biopsy does not necessarily mean you have breast cancer. In fact, according to the National Breast Cancer Foundation, 80 percent of women who undergo a breast biopsy do not have breast cancer. The only way to know for sure is through a biopsy, and wouldn't you rather have the facts instead of spending your time worrying?
Unfortunately, in order to know the full status, staging, and proper course of treatment for your condition, this isn't an exam you'll be able to skip. The good news is that breast biopsies are considered a standard type of breast cancer treatment and should be covered by insurance.
Some patients may decide to seek out a second opinion either before or after they have undergone a breast biopsy. Most health plans cover second opinions as well, provided they are conducted by an in-network healthcare provider. As always, it;s a good idea to confirm the extent of coverage with your insurance provider before scheduling.
In most cases, no preparation is needed before a breast biopsy. Please bring a CD of your prior studies if your prior breast health studies were performed outside of Memorial Hermann. If you need us to request your prior films from another facility, please complete a medical release of information form and return it to our facility prior to your appointment. Once received, we will request the films. Comparison with prior imaging is key to assessing for change and accurate diagnosis. Otherwise, you should prepare for a breast biopsy the same as you would for a standard breast exam:
Your experience with a breast biopsy will vary depending on the type of biopsy required. The procedure may take place in your doctor;s office, the radiology department of a hospital, or an operating room. In any case, you will be given a local anesthetic for pain management while the biopsy is performed. A small incision will be made in the skin of your breast and the tip of the biopsy needle will be advanced toward the site of the lesion. If at any point you feel pinching or pain, notify the doctor and they will stop to apply more anesthetic.
During a fine- or core-needle biopsy, a small amount of cells will be taken and the needle removed. If a vacuum-assisted device is used, anywhere from 3-6 samples will be taken. Sometimes, this will lead to the lesion being mostly or completely removed; a small clip will be left at the biopsy site so it can be easily located if the lesion proves to be cancerous. If there is no cancer, the clip will not need to be removed.
Though the idea of a doctor taking a tissue sample from your body may sound scary, in actuality the breast biopsy process is fairly quick and painless. You will receive a local anesthetic that;s strong enough to numb the affected area. You won't feel any pain from the initial (small) incision nor the tissue sampling, though you may feel some pressure during the procedure.
You may feel a bit tender for a few days after the biopsy, and there may be some bruising, but no more than if you'd been given a booster shot. If this soreness becomes bothersome, you can take simple pain medicine such as acetaminophen (Tylenol). However, avoid any medications that contain aspirin - they thin the blood and can increase bruising or bleeding from the biopsy site.
If you follow these simple instructions, you can resume your normal daily routine immediately. The small incision will heal in a few days.
Unfortunately, there's no one-size-fits-all estimate. The time it takes to complete a breast biopsy depends on the type of biopsy being performed. For example, a simple procedure like fine needle aspiration can be done in your doctor's office in just a few minutes. On the other hand, stereotactic breast biopsies and ultrasound-guided core biopsies require the use of specialized imaging equipment operated by trained technicians. These types of biopsies can take anywhere from 30 minutes to an hour to complete.
At Memorial Hermann, we understand that your time is very important. Our professional, courteous staff will do their best to make sure your breast biopsy is completed as quickly and safely as possible so you can get back to your daily routine.
Once the procedure is complete, biopsy samples will be sent to the hospital pathology departments at Memorial Hermann for further study. Though you may be anxious to know the results right away, keep in mind that the technologist who administers the test is not allowed to interpret or discuss what they are viewing while performing the biopsy.
Your biopsy samples will be examined by a team of clinicians and a pathology report will be sent to your primary care physician after a few days. By this time, your doctor should have already scheduled a follow-up appointment with you to go over the results.
Studies show that 1 in 8 women in the U.S. will develop invasive breast cancer over the course of her lifetime. It's likely that this disease has affected or will affect your life and the lives of those you love. You owe it to yourself - and those who care about you - to take charge of your health by scheduling a regular breast cancer screening and following your doctor's advice for treatment. Undergoing a biopsy may sound scary, but the only way to beat breast cancer is to face it head-on before it gets out of control.