When a lump or abnormal area is identified, a biopsy is needed to establish a diagnosis. About 80% of breast biopsies are benign (non-cancerous).
Prior to the diagnostic procedure, the radiologist goes over in detail the benefits and potential risks with the patient. If there are additional questions following the procedure, the patient is invited to call the referring physician.
Biopsy techniques that may be used include:
The Evergreen Breast Center is nationally certified for this minimally invasive procedure, which establishes the precise diagnosis of a breast problem without the need for a surgical biopsy.
Stereotactic means that images are taken from several different angles and represents a 3-D image that is used to guide the biopsy instrument with the aid of a computer. The patient is placed face down on a stereotactic table with the affected breast suspended through a hole in the table. The breast is lightly compressed to stabilize it. The table is connected to a computer that processes digital images. Low dose digital mammographic images are obtained to locate the abnormality.
The radiologist will inject a local anesthetic and will make a small nick in the skin (less than ¼ inch) which will not require stitches. A computer guides the biopsy probe to the tissue for sampling which is then sent to pathology for analysis. A tiny metal clip may be left behind as a marker of the abnormality which has been completely removed. A small bandage will be placed over the incision site.
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A fine needle aspiration is a diagnostic sampling procedure. A very small needle is inserted into a discrete, defined mass in order to draw up some of the cells/contents of the mass for diagnostic purposes. Ultrasound is used to guide a needle for the aspiration.
The patient is placed on a cushioned table, slightly turned to one side with a foam cushion to support her back. The radiologist injects a local anesthetic, and under ultrasound guidance a small needle will be gently placed into the breast through which cells are removed from the abnormality (aspirated). If the abnormality is fluid, then the aspiration removes it all. If solid, the radiologist will remove a small core of tissue. Pressure and an ice pack are applied for patient comfort, and a small bandage is placed over the insertion site.
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A breast core biopsy allows sampling of breast tissue to be examined by a pathologist. A core biopsy is a minimally invasive procedure that establishes the precise diagnosis of a breast problem without the need for a surgical biopsy. Ultrasound is used to guide a needle for the core biopsy.
The patient is placed on a cushioned table, on her back, slightly turned to one side with a foam cushion to support her back. The radiologist injects a local anesthetic, making a small nick in the skin (less than ¼ inch) which will not require stitches. A small needle is gently placed into the breast with ultrasound guidance. Several small tissue samples are obtained, and sent to pathology for analysis. Pressure and an ice pack is applied to the breast for any discomfort, and a small bandage is placed over the small incision
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This minimally invasive procedure establishes a precise diagnosis of a breast problem without the need for a surgical biopsy. MR is utilized to localize the abnormality if it can’t be seen by mammography or ultrasound.
The procedure allows the surgeon to remove a small amount of breast tissue for the pathologist to make a definitive diagnosis. A small needle containing a wire will be inserted into the abnormal area after local anesthesia is provided. After the location of the needle is verified by additional MR imaging, the needle will be removed, leaving the wire in place in order to guide the breast surgeon to the abnormality during surgery.
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Breast scintigraphy enables the surgeon to sample specific lymph nodes to determine whether cancer has spread beyond the breast. In certain circumstances, Breast Scintigraphy can help the radiologist determine the difference between a benign or a malignant lesion.
A breast scintigraphy is performed in nuclear medicine. Radioactive material is injected around the breast cancer or around the breast cancer biopsy site. The patient lies down on a table while images similar to X-ray pictures are taken of the breast cancer site. The patient is then taken to the operating room where a surgeon injects about a teaspoon of blue dye around the breast cancer or biopsy site to assist in localizing the sentinel node. The gamma probe will also be used to locate the targeted sentinel lymph node.
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A wire localization assists a surgeon in locating a breast abnormality not felt on a manual breast exam.
The procedure allows the surgeon to remove a small amount of breast tissue for the pathologist to make a definitive diagnosis. A small needle containing a wire will be inserted into the area of concern after local anesthesia is provided. After the location of the needle is verified by additional mammographic views or ultrasound, the needle will be removed, leaving the wire in place in order to guide the breast surgeon to the abnormality during surgery.
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A sentinel lymph node biopsy is performed to determine if invasive breast cancer has migrated out of the original tumor location via a targeted lymph node under the armpit. This procedure prevents the necessity of surgically removing 2/3 of lymph nodes under the armpit, which is significantly more invasive. On the day of a patient’s breast surgery, if a sentinel node biopsy is recommended by a member of the breast cancer medical team, the patient will first undergo a lymposcintigraphy exam in diagnostic imaging, nuclear medicine.
A lymphoscintigraphy is performed by injecting radioactive material around the breast cancer or around the breast cancer biopsy site. The patient lies down on a table while images similar to X-ray pictures are taken of the breast cancer site. The patient is then taken to the operating room where a surgeon injects about a teaspoon of blue dye around the breast cancer or biopsy site to assist in localizing the sentinel node. The gamma probe will also be used to locate the targeted sentinel lymph node.
A standard lumpectomy or mastectomy will precede the sentinel node biopsy. The surgical wounds are closed using surgical techniques. The sentinel lymph node, breast tissue are sent to a pathologist for analysis. The doctor informs the patient whether the lymph node is positive or negative for cancer.
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A galactogram or ductogram is a procedure that is sometimes helpful in determining the cause of nipple discharge.
Cream is placed on the nipple for local anesthesia, along with warm compresses to help stimulate a nipple discharge. The radiologist inserts a small catheter into the nipple through which X-ray dye will be injected. The technologist then takes several low dose mammograms of the breast, after which the catheter is removed.
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