Needle biopsy is a simple procedure that allows a small amount of tissue to be removed from the breast so that it can be examined under a microscope by a pathologist. (A pathologist is a medical specialist who studies how changes in tissues relate to disease.) It is most often used to diagnose a "feelable" lump or abnormal tissue detected on a mammogram or ultrasound. In many cases, mammograms and ultrasound give enough information to diagnose breast cancer. If the diagnosis is uncertain, breast tissue samples will be taken either with a needle biopsy or surgery.
As the name "needle biopsy" suggests, tissue samples from the breast are obtained with needles rather than surgery. The advantage of needle biopsy over surgery is that it leaves little or no scarring, and is less costly. With surgery, scar tissue that forms inside the breast can temporarily interfere with the interpretation of subsequent mammograms (see Figure 1). With the surgical option, the entire lump is removed, often using local anesthesia. It is a simple procedure where the patient enters and leaves the hospital on the same day.
Scar tissue after surgical biopsy.
Compared to surgery, a needle biopsy obtains only a small portion of the abnormal tissue and can be less accurate. This error tends to decrease as the needle size increases. The accuracy of needle biopsy depends on the following:
As well, the larger the needle the greater the cost, with the directional vacuum-assisted needle biopsy device being the most expensive, and fine-needle assisted biopsy the least expensive. Also, larger needles can leave small marks. Both the large-core needle biopsy and the directional vacuum-assisted needle biopsy require an initial puncture in the skin made with a scalpel blade.
It is important to discuss your options with a genetic counsellor before having genetic testing done so that you are informed of all of the benefits and consequences of the test. It may also be a good idea to talk to other women who have had genetic testing done to see how it has affected their lives.
If you test positive for one of the breast cancer genes, there are several options for decreasing your chances of developing breast cancer, if you should choose to do so, including closer screening, surgery, hormonal therapy, or lifestyle changes.
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