Breast biopsy is prescribed by a mammologist for various reasons, but first of all this procedure is carried out in order to exclude the oncological nature of the detected neoplasm. Puncture biopsy is a sampling of cellular material for pathomorphological analysis. Manipulation can be performed surgically, by special devices or syringes with the help of special needles of different thicknesses. The procedure is performed by the oncologist, and in some cases, she is obliged to undergo the control of a narrowly specialized specialist( ultrasound and / or digital mammogram).
Breast biopsy is recommended for detection of neoplasms, obvious structural disorders of the skin, the presence of secretions, ulcers near the nipple. Puncture of the breast is not performed in the presence of acute respiratory and infectious diseases, elevated temperature, allergic reaction to pain medication, during pregnancy and during breastfeeding.
Breast biopsy types
During the diagnosis, the doctor may prescribe one or more procedures:
- for cytological examination - puncture fence techniques;
- for histological analysis - excision of part of tumor, taking samples of trepan tissue with instrumentation.
Vacuum and puncture biopsies of the breast
Any puncture of the breast should not be performed as a routine examination and should be performed only before the beginning of treatment.
Methods of taking cells for morphological study using invasive needles are highly reliable( 88%), availability, unlimited repetition and simplicity. Puncture of the breast and its results are very important in case of suspected tuberculosis of the gland, galoktazazy, 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 of treatment of the breast mammary gland, the size of which exceeds 1.5 cm - after puncturing and sucking the fluid, the walls of the lesion are glued together.
In order to avoid consequences, in cases where there is a suspicion of a scirrhous tumor, the hyalinoid fibroadenoma or sampling of the tissue sample will be made from deep small tumors, the oncologist performing the manipulation must have experience and certain skills.
Depending on the objectives pursued, different procedures can be used for the procedure:
- Vacuum or aspirating. Aspiration of tissue - is "sucking" the desired fragments, by creating a reduced pressure. The cells are sucked through the needle into a special device. Aspiration biopsy, under the control of ultrasound, and also features of the device, allowing to change its position inside the gland, allow to take up to 10 samples per puncture.
- Puncture. This technique uses a manual or automatic syringe. The drawbacks are that during the puncture, you can take only one sample and to detail the extensive tumor will require 5 to 7 procedures.
Depending on the thickness of the needle, a biopsy of the breast( vacuum or puncture) can be performed in one of three ways. In the case of carrying out vacuum diagnostics, the name "aspirating" will be added to the name. All the diameters of the needles make it possible to do without suturing.
- Fine needle biopsy. Basically fine needle puncture of the mammary gland is performed by aspiration( vacuum).This is a simple and painless technique. The sampling of the biopsy by a thin needle is suitable for taking liquids. The puncture is quick and does not hurt. The puncture site is previously disinfected and anesthetized( locally).The skin of the breast is minimally traumatized. Fine-needle manipulation generally takes about 20 minutes and is performed under sterile conditions. An additional safety guarantee is provided by preliminary ultrasound and mammography. Thick-needle biopsy. Such a study is prescribed when there is a suspicion of a cyst or the boundaries of the lesion are vague, as well as when it is necessary to take a large amount of material. A thick needle is used for sampling tissue samples. For anesthesia, an injection of a local analgesic is selected. Typically, a breast biopsy with a thick needle is performed not by a vacuum method, but by the usual taking of a puncture.
- Stereotactic biopsy. This manipulation removes histological material( biopsy) from several sites with a single( thin, thick) needle. Such a puncture of the mammary gland is carried out only after preliminary preparation - the performance of several X-rays taken at different angles. For monitoring, you need a mammogram and 2-3 ultrasound machines. Stereotactic breast biopsy is designed to study tumors of deep localization.
Trepan breast biopsy
In some cases, before the start of radiation therapy, a more in-depth cytological examination is needed. Trepan 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, trepan biopsy is performed directly during the surgical operation, which is performed under general anesthesia:
- taking tissue samples, for subsequent postoperative diagnosis - sectoral resection;
- use of trepan tools and elektrokoagulyatora for the treatment of large cysts - the burning of walls without epithelial lining.
During the operation, a general or local treatment is used, and during the diagnostic manipulation - local anesthesia. Abuse of trepan biopsy is unsafe and must be justified.
Surgical biopsy of the breast
Special medical wire is used for surgical biopsy. This procedure is carried out with the justified necessity of monitoring and controlling the dynamics of neoplasm development. After the material is taken, a special mark, clearly visible on the ultrasound, is placed.
Before and after diagnostic biopsy
Breast biopsy performed for diagnostic purposes does not require special preparation and consists of a weekly abstinence from taking some( to check with a doctor) medications that may affect the analysis;aspirin and others, blood thinning or reducing coagulability, drugs. On the day of the procedure it is forbidden to use hygienic and perfumery lotions and deodorants.
After the procedure, it is advisable to rest for a day. Recommended admission of acetaminophen( Tylenol®) and further abstinence from aspirin and anticoagulants. It is forbidden to visit the pool, sauna and bathing for 7 days. Water procedures - warm washings and showers, are allowed in a day. Doing attachments to the ice puncture site can only be done within 3 hours after the procedure and in the mode - 20 minutes of ice compress: 10 minutes pause. For several days, the puncture site should be lubricated with an antibiotic ointment and protected with a sterile bandage.
Consequences of
The most unpleasant result occurs when the oncologist does not have enough experience. Then he can admit:
- puncture the tumor with hematoma and / or infection of the wound, may lead to further growth of the tumor;
- perforation of the subcutaneous veins and hematomas can lead to erroneous results of the analysis and the appointment of inadequate treatment.
But, with an experienced specialist, there is nothing to be afraid of. Possible complications - bleeding from the puncture site, edema of the gland, bruising, fading pain - will be resolved in a few days.
You need to urgently go to the institution where the breast biopsy was performed, if bleeding started from the puncture site, which does not stop for 10 minutes and / or there were discharge from the nipple, or body temperature rose to 38.3 ° C.
The results of
In the pathology, the size, color, consistency, localization of the biopsy specimen is described in detail and the results obtained are assigned to one of the groups:
- is incomplete - the procedure must be repeated;
- normal - analysis describes the normal structure of cells without additional inclusions;
- benign - the examined compaction does not belong to tumor formations, for example, cyst;
- is non-cancerous - describe a tumor consisting of unmutated cells, for example fibroadenoma;
- cancer - contains information about the type of cancer cells and characterizes their dependence( or not) on hormones.
The conclusion of a morphological study determines the further treatment tactics and how many radiation units are necessary for the effectiveness of radiotherapy.
Early results will be ready in 2-3 days. A complete analysis is done in 10-14 days.
