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 It is similar to a fine needle aspiration, except a larger needle is used, and the sample withdrawn is also larger.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 oncologists.
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.