Our Summary

This research paper talks about a common procedure known as core needle biopsies, which are often used to check for breast cancer. These biopsies are typically guided by ultrasound images to accurately locate suspicious areas in the breast or axilla (armpit). The procedure is usually carried out by radiologists who use different imaging techniques such as mammograms, ultrasounds, and MRI scans. Sometimes, this procedure is performed by interventional radiologists in certain settings.

The paper emphasizes the importance of understanding the complete breast imaging process. This is not only crucial for accurately locating the area that needs to be biopsied but also to ensure that the radiological findings align with the pathology results.

The correct positioning, technique, and post-biopsy care are vital for the success of the procedure and the overall care of the patient. The paper discusses the indications for a biopsy, strategies for accurate targeting, how to perform the biopsy, considerations after the biopsy, and the importance of radiologic-pathologic concordance (ensuring that the radiological findings agree with the pathology results). This discussion includes recommendations from the American College of Radiology about how to perform ultrasound-guided percutaneous (through-the-skin) breast interventions.

FAQs

  1. What is the standard of care for biopsy of suspicious findings within the breast and axilla?
  2. Who typically performs ultrasound guided breast biopsies and why is complete breast imaging knowledge important?
  3. What are some key considerations after a breast biopsy procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about breast biopsy is to make sure to follow all pre-biopsy instructions given by the healthcare provider, such as avoiding blood thinning medications and not eating or drinking for a certain amount of time before the procedure. It is also important to inform the healthcare provider of any allergies or medical conditions before the biopsy. After the biopsy, it is normal to experience some bruising and discomfort, but if there is excessive bleeding, swelling, or signs of infection, it is important to contact the healthcare provider immediately. It is also important to follow up with the healthcare provider for the results of the biopsy and any further recommendations for treatment or follow-up care.

Suitable For

Patients who are typically recommended for breast biopsy include those with suspicious findings on imaging studies such as mammograms, ultrasounds, or breast MRIs. These findings may include suspicious masses, calcifications, or areas of abnormal tissue. Patients with a personal or family history of breast cancer, as well as those with symptoms such as a breast lump or nipple discharge, may also be recommended for biopsy. Additionally, patients with a history of high-risk breast lesions, such as atypical ductal hyperplasia or lobular neoplasia, may be recommended for biopsy to further evaluate their risk of developing breast cancer. Ultimately, the decision to recommend a breast biopsy is based on a thorough evaluation of the patient’s individual risk factors and imaging findings by a multidisciplinary team of healthcare providers.

Timeline

Before breast biopsy:

  1. Patient undergoes imaging studies such as mammogram, ultrasound, or MRI that reveal a suspicious lesion in the breast.
  2. Patient may have a discussion with their healthcare provider about the need for a biopsy and the risks and benefits involved.
  3. Patient may have blood tests or other preoperative evaluations done to ensure they are healthy enough for the procedure.
  4. Patient may receive instructions on how to prepare for the biopsy, such as avoiding certain medications or fasting before the procedure.

After breast biopsy:

  1. Patient is positioned on the exam table and the area to be biopsied is cleaned and numbed with a local anesthetic.
  2. A small incision is made in the skin and a needle is inserted to remove tissue samples from the suspicious area.
  3. The tissue samples are sent to a pathology lab for analysis.
  4. Patient may experience some discomfort or bruising at the biopsy site, which can be managed with over-the-counter pain medication.
  5. Results of the biopsy are typically available within a few days to a week, and the patient will receive follow-up instructions based on the findings.
  6. If the biopsy confirms the presence of cancer, the patient will be referred to a breast surgeon or oncologist for further treatment options.

What to Ask Your Doctor

  1. What is the purpose of the biopsy?
  2. What are the potential risks and complications associated with the biopsy procedure?
  3. How will the biopsy be performed (e.g. ultrasound-guided, stereotactic-guided, MRI-guided)?
  4. Will local anesthesia be used during the biopsy procedure?
  5. How long will the biopsy procedure take?
  6. Will I need to take any special precautions before or after the biopsy?
  7. How soon will I receive the results of the biopsy?
  8. What will happen if the biopsy results are inconclusive?
  9. What are the next steps if the biopsy results are positive for cancer?
  10. Are there any restrictions on activities or medications following the biopsy procedure?

Reference

Authors: Winkler NS. Journal: Tech Vasc Interv Radiol. 2021 Sep;24(3):100776. doi: 10.1016/j.tvir.2021.100776. Epub 2021 Oct 2. PMID: 34861968