Your primary care provider may refer you to a surgeon based on your physical exam and/or your mammogram results. The surgeon will determine the most appropriate method of performing the biopsy, EG fine needle aspiration, core biopsy, stereotactic biopsy, or an excision (or open) biopsy.
Fine Needle Aspiration
Fine needle aspiration is a procedure in which a small needle is inserted into a
breast lump to withdraw a sample of fluid or a small cluster of cells. It is minimally-invasive,
and is often used when a lump is suspected to be a cyst. It can be used either as
a biopsy procedure, or simply to drain the fluid from a cyst, and may be done using
a local anesthetic.
A stereotactic biopsy procedure uses a special mammography machine to locate a lesion
under x-ray guidance. It then determines the correct angle and depth needed to place
the needle tip into the abnormal area to remove tissue samples. A physician performs
the procedure with the assistance of a technologist, while the person is positioned
in a lying-down (prone) position. It is done with local anesthesia, followed by
placement of a small bandage.
Sentinel Node Biopsy
A sentinel node biopsy is done to determine whether and how far cancer has spread
into the lymph nodes. The procedure is done in our Nuclear Medicine department.
During a sentinel node biopsy, a radioactive substance and/or a blue dye are injected
into an area around a tumor. The material is carried to the sentinel node, which
is a lymph node near the tumor. The sentinel node is removed during surgery and
is examined for cancer. If it contains cancer cells, more lymph nodes are removed
from the armpit. But if it free of cancer, the patient can avoid having further
lymph node surgery.
A core biopsy is a procedure in which the breast is first numbed with a local anesthetic,
and then a hollow needle is inserted into the lump to draw out a small tissue sample.
It is similar to a fine needle aspiration, except a larger needle is used, and the
sample withdrawn is also larger.
Excision or Open Biopsy
Open biopsy is a procedure in which an incision is made in the breast, and all or
part of a lump is removed for examination. It is a surgical procedure, typically
requiring sedation and local anesthesia, or sometimes general anesthesia, and it
is performed in an operating room at the hospital. Depending upon the results of
your biopsies, your surgeon may also discuss with you further treatment. In the
event that a lump is determined to be malignant (or cancerous), your surgeon will
talk with you about possible surgical treatments, and about other potential treatment
options. You may be referred to the Oncology Department to talk with the medical
If the lump is determined to be cancerous, some procedures your surgeon may discuss
with you include:
Lumpectomy is a surgical procedure in which a breast lump and an area of normal
tissue surrounding the lump are removed. It is often used for women who have small,
localized breast cancers. Lumpectomy is also called breast-sparing surgery. After
breast-sparing surgery, most women receive radiation therapy to destroy cancerous
cells that may remain in the area.
Mastectomy is a procedure in which all or a large portion of a woman's breast is
surgically removed. The procedure is done under general anesthesia. Mastectomy may
or may not be followed by breast reconstruction.
A Note to Patients:
We recognize that a breast cancer diagnosis creates a frightening time for any woman.
While you always have a voice in your healthcare decisions, your doctor may recommend
to you the treatment plan that he or she feels is best for you. Please do not hesitate
to ask your doctor any questions you may have, or let them know if there is something
you don't understand. Our breast health educator is also available as a resource
to you. For more information about LRGHealthcare's Surgical Services, including
our Laconia, Franklin, and Ambulatory Surgery Center at Hillside Medical Park facilities,
please visit our Surgical Services page.