 |
Risks of percutaneous
breast biopsies include:
- Bruising (scarring is usually minimal)
- Infection
- Hematoma: pooling of blood trapped
inside the biopsy area
In general, risks are small and even
when one or more of these complications do occur, they usually resolve within a brief
period of time with the proper medical attention.
Open surgical
breast biopsy carries some additional risks:
- Typically requires sutures (stitches)
and may leave a scar, depending on the size of the excision
- May change the shape or appearance of
the breast depending on the size and location of the lesion (breast abnormality)
- As with all procedures that involve
sedation and/or anesthesia, there is a very small but measurable risk of mortality
(due to risks of anesthesia)
- A greater chance of bleeding, infection,
or wound healing problems compared with less invasive needle biopsy procedures
- A possibility, albeit rare, that the
wire used to guide the needle to the lesion may break deep within the breast in the case
of wire-localized excisional biopsy
- Usually requires at least one day of
recuperation at home
The side effects of breast biopsy will
vary depending on the patient. Patients are encouraged to discuss the risks of breast
biopsy before undergoing the procedure.
Though not common, it is possible for a
biopsy to reveal a false-positive (i.e., indicates cancer when it is really not present)
or false-negative (i.e., misses a cancer when it really is present) result. False-positive
and false-negative results may be caused by the following: technical problems with the
biopsy equipment, not sampling the correct tissue area, the method of biopsy performed was
not suitable for the lesion(s) present. The latter may not be known until after the biopsy
is performed and may indicate the need for additional testing or a different method of
biopsy if there is a question about the result.
False-Positive/False-Negative
Breast Biopsy Results May Be Caused By:
- Technical problems with the biopsy
equipment
- The biopsy did not sample the correct
tissue area
- The method of biopsy performed was not
suitable for the lesion(s) present
|
For example, if a fine needle aspiration (FNA) biopsy was performed, it may reveal only
have picked up cells that reveal a benign (non-cancerous) condition, even though a
suspicious palpable (felt) lump is present.
If the radiologist or surgeon is still
concerned, the results of the FNA may be discounted and the FNA may be repeated with an
attempt to sample additional areas of the mass. Or, another type of biopsy such as core needle or open surgery biopsy may be
recommended. At times, if there is a relatively low level or suspicion, the patient may be
closely monitored with follow up exams and imaging studies to determine whether the
appearance or behavior of a mass changes with time.
Summary of Breast Biopsy Methods
Summary of Breast Biopsy Methods |
| Type |
Used
For |
Needle/ Sample size |
Anesthesia |
Pros |
Cons |
| Fine Needle Aspiration (FNA) |
Cysts;
sometimes also used to sample cells from masses with or without calcifications |
22
or 25 gauge needle; several (5-6) samples of fluids and/or cells are removed |
Local
or none |
Fastest
and easiest method; results rapidly available; no stitches or scar; excellent for cysts |
Small
sample size may cause incomplete assessment or misdiagnosis; multiple needle insertions;
operator dependent |
| Core Needle |
Sample
tissue from solid mass or calcium deposits |
10,
11, or 14 gauge needle; several (5-6) samples are removed |
Local |
Larger
sample than FNA can lead to more accurate diagnosis; no stitches or internal scar |
Multiple
needle insertions; limited sample size may underestimate more serious diagnosis |
| Vacuum-Assisted (Mammotome or MIBB) |
Primarily
used for calcifications |
11
or 14 gauge needle. Requires 0.25 inch incision (approx. 0.6 cm); several (8-10) samples
are removed |
Local |
Excellent
for calcium deposits; removes several large samples with one needle insertion; no
stitches; minimal scar |
May
be less accurate than surgical biopsy which removes entire lesion; not ideal for
hard-to-reach lesions (i.e., near chest wall); operator dependent |
| Large Core Surgical (ABBI) |
Primarily
used for nonpalpable (unable to feel) masses and/or calcifications |
5mm-20mm
cylinder of breast tissue is removed (approx. size and shape of wine cork) |
Local |
Provides
large sample without heavy sedation (as with surgical biopsy) |
Removes
large amount of normal tissue before reaching lesion, may not remove adequate margin of
tissue around lesion; requires stitches; scar |
| Open Surgical |
Masses,
hard-to-reach lesions, (i.e. near chest wall) multiple lesions; masses with
micro-calcifications |
Requires
1.5 to 2 inch incision (approx. 4.0 to 5.0 cm); golf ball size area of tissue or more is
removed |
Heavy
sedation; sometimes general anesthesia |
Yields
largest tissue sample; most accurate method of diagnosis (near 100%) |
Causes
permanent scar that may make future mammograms difficult to read; possible breast
disfigurement; requires stitches and longer recovery |
Updated: May 4, 2008
< Prev | 1 | 2
Return to Breast Biopsy Main Menu |
