Breast biopsy - precise diagnosis of ambiguous lesions of the breast
Breast biopsy is the only examination that allows precise diagnosis of lumpy lesions located in the mammary gland. It is performed to deepen the diagnosis and to evaluate suspicious changes detected by mammography, ultrasound or MRI. The current standard is the classic core-needle biopsy or mammotomic (vacuum-assisted) biopsy. A core-needle biopsy involves taking fragments of the tumour for histopathological examination. The test result will determine whether the lesion is benign or malignant (i.e. cancer) of the breast. A breast biopsy can be performed in an operating room or on an outpatient basis. It is a minimally invasive examination.
Core needle biopsy (CNB)
For any type of CNB, a thin needle is used to put in medicine to numb the skin under local anaesthetic. Then a small cut (about ¼ inch) is made in the breast. The biopsy needle is put into the breast tissue through this cut to remove the tissue sample of 1.5-2 cm long. As individual tissue samples are taken several times, a needle needs to be inserted into the breast several times. A core-needle biopsy makes it possible to take biopsy specimen of the tissue and, as a result, it gives precise possibilities to evaluate the examined tumour. However, it is not possible to remove the lesion completely.
Vacuum Assisted Breast Biopsy (VABB)
Mammotome biopsy is a modern and low-invasive technique used to diagnose breast cancer.
For mammotome biopsy a fragment of an ambiguous tissue lesion is harvested using the high suction force of a vacuum assisted device.
The procedure begins with anaesthesia of the skin and tumour area. The needle is placed under the lesion through the opening and then the fragment is “cut”, sucked into a special opening in the needle and then transferred into a special container for biopsy specimens. It is carried out on an outpatient basis (takes about 10 – 20 minutes). After the procedure the patient can go home. There are no stitches, only a pressure dressing, which is removed after 1 day.
Such a breast examination allows for a very precise diagnosis of changes in the breast. it is characterised by high sensitivity and specificity of the obtained results. It allows the resection of most benign lesions in their entirety, without the need for surgery in a hospital setting.
Advantages:
- Precise method – we remove only the suspicious lesion without damaging the surrounding tissues, one skin cut of 2-3 mm length
- Safe method – under local anaesthesia, does not require special preparation, does not require general anaesthesia
- Reliable method – the size of biopsy specimens allows precise histopathological diagnosis, the percentage of false negative results is lower
- Fast method – the whole procedure usually takes 10-20 minutes
Dr Daniel Maliszewski's opinion::
“At the moment, the standard in breast cancer diagnosis is the core needle biopsy, and mammotomic biopsy has become a very important part of the diagnosis of ambiguous lesions in the breast gland. Its advantages allow us to avoid open surgical biopsy in the hospital setting, and we have been able to eliminate fine needle aspiration biopsy – a technique with significantly lower sensitivity and specificity. In my practice, mammotomic biopsy is an integral part of daily diagnostics in the Breast Clinic.
Daniel Maliszewski, MD