Sometimes the only way to tell what a finding on a breast imaging study represents is to obtain tissue for the pathologist to analyze. In the not so distant past, biopsies were almost exclusively obtained surgically. However, many cases can be resolved with non-surgical interventional needle biopsies and thus avoid surgery. These needle biopsies are performed with imaging guidance by either using ultrasound or special mammography equipment called stereotactic biopsy. The advantages of these methods include the avoidance of a surgical procedure, obtaining a diagnosis quickly, less subsequent breast pain and swelling, and no scarring. Since between approximately 60% – 80% of breast biopsies have benign outcomes, these needle biopsies offer distinct advantages in cases where they are applicable. In cases where cancer is diagnosed, a fully planned cancer surgical approach can then be performed. This gives the surgeon the advantage of knowing ahead of time, so that many repeat surgeries can be avoided.
When a suspicious abnormality is detected by mammography, a Stereotactic Biopsy may be performed. Stereotactic breast biopsy is a safe and minimally invasive form of breast biopsy. It is used to obtain tiny samples from an abnormal breast mass for examination by a pathologist. This biopsy is performed using a computer and x-ray technology to position a hollow biopsy needle. Biopsies are the only definitive way to confirm whether suspicious breast tissue is normal or abnormal.
Ultrasound Guided Biopsy
Following a breast ultrasound, a biopsy using ultrasound, or sound waves, may be performed. Ultrasound imaging is used to assist with proper positioning of the biopsy needle so a small sample of tissue can be obtained and then analyzed under a microscope. Ultrasound guided biopsy is a highly effective way to evaluate abnormal tissue within the breast.
MRI Guided Breast Biopsy
MRI-Guided Breast Biopsy is usually a preferred alternative to surgical biopsy. It is a recent development and important for diagnosing breast cancer. When a Breast MRI uncovers suspicious areas, an MRI-Guided Breast Biopsy may be performed to help isolate the problem and provide an accurate interpretation by one of our Radiologists.
Aspirations and Core Needle Biopsy
Many suspicious breast abnormalities can be diagnosed without surgery by using needle biopsy. In the past, excisional surgery biopsy was the only option for this purpose. There are two types of needle biopsies – fine needle aspiration biopsy and core needle biopsy. Fine needle aspiration uses a very thin needle to remove fluid and tiny fragments of tissue. Core needle biopsy uses a slightly larger needle to remove a cylindrical piece of tissue about 1/16 inch in diameter and 2 inches long. Core needle biopsy is the preferred method because fine needle aspiration is difficult due to the small amount of tissue extracted maybe inadequate.
But, even if an abnormality is too small to be felt, fine needle aspiration or core needle biopsy can still be done using breast imaging methods such as ultrasound and stereotactic mammography to guide the needle into the lesion. During an ultrasound examination, the physician can view the needle on a screen as it moves toward and into the mass.