Breast Biopsy

Several methods breast biopsy now exist. The most appropriate method of biopsy for a patient depends upon a variety of factors, including the size, location, appearance and characteristics of the abnormality.

Fine Needle Aspiration

(FNA) Fine needle aspiration (FNA) is a percutaneous ("through the skin") procedure that uses a fine needle and a syringe to sample fluid from a breast cyst or remove clusters of cells from a solid mass. With FNA, the cellular material taken from the breast is usually sent to the pathology laboratory for analysis. A technique similar to FNA can also be used by the radiologist or surgeon to drain fluid from a benign cyst. This procedure is called cyst aspiration. A Fine Needle Aspiration procedure is generally almost painless and takes only a few minutes to perform.

Core Needle Biopsy

A core needle biopsy is a procedure that removes small but solid samples of tissue using a hollow "core" needle. For palpable (“able to be felt”) lesions, the physician fixes the lesion with one hand and performs a freehand needle biopsy with the other. In case of non-palpable lesions stereotactic mammography, or ultrasound, or PEM guidance is used. With stereotactic mammography it is possible to pinpoint the exact location of a mass based on images taken from two different angles of the x-ray machine. With ultrasound, the radiologist or surgeon can watch the needle on the ultrasound monitor to help guide it to the area of concern. With PEM (positron emission mammagraphy), the lesion is targeted in 3D based on a positron emission tomography (PET) image of the breast. The needle used during core needle biopsy is larger than the needle used with FNA. The core biopsy needle also has a special cutting edge allowing removal of a bigger sample of tissue. With Core Needle Biopsy a relatively large sample can be removed through a small single incision in the skin. Typically, the breast area is first locally anesthetized with a small amount of anesthetic fluid. Then, the needle is placed into the breast. As with FNA, the radiologist or surgeon will guide the needle into the area of concern by palpating the lump. If the lesion can't be felt the core needle biopsy is performed under image-guidance using either stereotactic mammography, ultrasound or even magnetic resonance imaging (MRI). A core needle biopsy procedure takes a few minutes to perform and is almost painless.

Vacuum Assisted Biopsy

Vacuum Assisted Biopsy is a version of Core Needle Biopsy using a vacuum technique to assist the collection of the tissue sample. The needle normally has a lateral (“from the side”) opening and can be rotated allowing multiple samples to be collected through a single skin incision. The Vacuum Assisted Biopsy procedure is similar to normal Core Needle Biopsy.