Approaches to Breast Biopsy
Today, there are several different methods of performing a biopsy, which is an outpatient procedure to determine if a lump is malignant or benign. Using a local anesthetic, the procedure requires no stitches. The different approaches may include types of needle core biopsy, vacuum-assisted biopsy, stereotactic or MR- and ultrasound-guided biopsy. Your radiologist will recommend the procedure that is expected to produce the highest accuracy based on the pattern, size or density of the lesion.
We know you’re anxious to get your results, so we strive to call you with preliminary findings in one to two days. If further tests are needed, we’ll tell you and explain about any more in-depth laboratory analysis requiring an additional week or two. Your doctor will review those additional results with you during your appointment.
Sentinel Node Biopsy
Approaches to breast cancer surgery are becoming less invasive and far less radical than former standards of care. One of these new techniques is sentinel node biopsy. Here’s how it works: The day before surgery to remove your tumor, you are injected with a harmless tracer substance or dye. When the surgeon operates to remove the lesion, the dye helps spot the sentinel lymph node. This is the first lymph node that drains through to the rest of the lymph nodes under the arm. It is called the “sentinel” lymph node because it is the first affected lymph node – it stands sentinel over the tumor, so to speak, and sounds the warning to other lymph nodes that the cancer has spread.
The sentinel node is removed and quickly biopsied. If cancer is found, it and all or most of the other lymph nodes are removed during the surgery. If not, you retain the remaining lymph nodes, avoiding possible long-term side effects or complications and affording you a faster recovery.
Laboratory Analysis
Tissue taken from a biopsy is analyzed in the laboratory, where a lot of information is determined before surgery. “It used to be that a pathologist would process tissue and conclude, ‘It looks like this, so this is what it is.’ It was black and white – breast cancer, yes or no,” according to Richard Schwab, M.D., a hematologist and medical oncologist who specializes in breast cancer at UCSD.
“Now we continue the process, using more specific assays and tests performed on the tissue based on antibodies and detected proteins. This is important for knowing how to treat breast cancer, the prognosis and which treatments will and will not work,” said Dr. Schwab. As a result, he added, today’s more sophisticated analyses allow the medical team to select the treatments that will have the highest degree of efficacy with the least toxicity.