BIOPSY OF
BREAST
By. Wanda Gusta rai
(WAG)
CLASSIFICATION / TYPES OF
BIOPSY
CLOSED INDIRECT BIOPSY
FNABC
Core needle biopsy (tru-cut,Abram’s, vim silverman)
Punch biopsy
Loop biopsy
Endoscopic biopsy
CLOSED IMAGE GUIDED BIOPSY
Stereotactic
Ultrasound, CT, MRI
O P E N DIRECT BIOPSY
Incisional
Excisional (marginal, wide local, radical)
INDICATION FOR BIOPSY IN
SURGERY
Any lesion that persists for more than 2
weeks with no apparent etiologic basis
Any inflammatory lesion that does not
respond to local treatment after 10 to 14 days.
Persistent hyperkeratotic changes in surface
tissues.
Any persistent tumescence, either visible or
palpable beneath relatively normal tissue.
Evaluation andmonitoring of tissue rejection
after transplantion –kidney and liver
CONTRAINDICATION
Uncontrolled bleeding diasthasis
Anticoagulant therapy
Over-whelming sepsis
Severe impaired lung function
Uncoperative patient
L ocal infection near thesite
BREAST BIOPSY
A breast biopsy is the removal of
breast tissue to examine it for signs of
breast cancer or other disorders.
Several different types of biopsy may
be done.
MOST COMMON CAUSES OF
BREAST LUMP
Fibroadenoma
Fibroadenosis
Breast abscess
Breastcyst
Breast cancer
TYPES OF BREAST BIOPSIES
There are two main types of biopsies:
Needle Biopsy
Open Biopsy
Your options for biopsy are determined by
whether the lump is palpable (can be felt) or non-
palpable (can not be felted), the location of the
lump and the woman’s general health.
NEEDLE BIOPSY
• A needle biopsy is a procedure that uses
a needle to remove tissue or cells from
the breast.
• There are two types of needle biopsies:
Fine Needle and Core Needle Biopsy
NEEDLE BIOPSIES
Fine Needle – A thin, hollow needle is used to
remove a sample of tissue. The procedure is
quick and can be done in a doctor’s office.
Core Needle – A larger needle is inserted
through a small incision in the skin, and a small
core of tissue is removed. This type of needle
biopsy is done with the assistance of
mammography or ultrasound imaging in a
doctor’s office or hospital outpatient clinic.
ADVANTAGES OF NEEDLE
BIOPSIES
Simple procedure – does not require surgery
Accurate
Quick – only takes a few minutes
Not painful
Inexpensive
Quick results
DISADVANTAGES OF
NEEDLE BIOPSIES
Entire lump is not removed
Open biopsy may be necessary
For Fine Needle Only:
Specialist needed to read results
In situ cancer not distinguishable from invasive
cancer
OPEN BIOPSIES
An open biopsy is a surgical procedure that
opens the breast to remove tissue.
There are two types of open
biopsies: Incisional and
Excisional
ADVANTAGES OF OPEN
BIOPSIES
Quick – takes only one hour
More accurate than a needle biopsy
Larger samples provide information for
treatment plan
Excisional Only:
Removes entire lump
May be the only surgical treatment needed
DISADVANTAGES OF OPEN
BIOPSIES
Surgical procedure
Expensive
Side effects such as infection or blood collection
under the skin
Excisional Only:
Removing tissue can change the look and feel
of the breast
TECHNIQUES OF BIOPSY
Technique:
• S k i n incision should be curvilinear and follow
the langerslines
• T h e entire lesion with 2 to 3mm of normal
appearing tissue surrounding the lesion is
excised if benign
• 2 – 3cm if malignant.
• Lesions within 5cm of areolar margin ----
circumareolar
• Tissue forceps should only be applied when
the lesion hasbeen clearly defined
T h e lesion can be shelled out in cases of suspected
fibro adenomas
Secure hemostasis
Drains should not be used
Wound closed in two layers
INCISIONAL BIOPSY
Removes only a portion of the lesion
Removal of a wedge of tissue including normal
tissue, also known as WEDGE BIOPSY
For lesions >1 cm diameter
Includes normal and abnormal tissues
May risk shedding malignant cells
Should not be done on pigmented or vascular
lesions
Record position, size, shape of lesion
INCISIONAL BIOPSY
√ Narrow, deep
X Broad, shallow
INCISIONAL BIOPSY
METHOD:
Administer local anesthetic
Identify junction between normal tissue and the
lesion
Stabilize then dissect the specimen
Place
specimen in
bottle
Suture wound
Female breast
The female breast
is either of two
mammary glands
(organs of milk
secretion) on the
chest.
Needle biopsy of the breast
A needle biopsy is performed
under local anesthesia. Simple
aspirations are performed
with a small gauge needle to
attempt to draw fluid from
lumps that are thought to be
cysts. Fine needle biopsy uses
a larger needle to make
multiple passes through a
lump, drawing out tissue and
fluid. Withdrawn fluid and
tissue is further evaluated to
determine if there are
cancerous cells present.
Open biopsy of the breast
An open biopsy can be
performed under local
or general anesthesia
and will leave a small
scar. Prior to surgery, a
radiologist often first
marks the lump with a
wire, making it easier for
the surgeon to find.
Thank You
