Biopsy

Breast core needle biopsy

The basic method of breast examination is X-ray mammography; its main goal is to detect cancer in preclinical state, before it becomes palpable.
In contrast to other neoplasm, breast neoplasm is curable if it is diagnosed in an early phase. This is the reason why in some countries, including Poland, there are screening programmes based on high quality mammography examination the aim of which is systematic examination of women without clinical symptoms of the illness. Routine mammography examination can show irregularities requiring further diagnosis – additional imaging or ultrasound examination. Sometimes it cannot be decided based on imaging only if the lesion is benign or malignant.

Biopsy is necessary, i.e. collecting tissue for microscopy examination which provides a clear answer as to the character of the lesion. There are two main methods of breast biopsy: surgical biopsy and transcutaneous biopsy: fine- and core-needle biopsy and vacuum-assisted core biopsy. Surgical biopsy is performed in an operating room under local or sometimes general anaesthesia. Although surgical biopsy is a definitive method of diagnosis and is still considered to be a standard method, it has a few faults: it is necessary to stay in hospital, the procedure is stressful, a scar is visible and a scar tissue which makes future examination more difficult. Trancutaneous biopsies are cheaper and less invasive than open surgical biopsy, what’s more they leave no scar and do not cause significant breast deformation. Most transcutaneous biopsies done for the verification of nodular lesions are performed under ultrasound guidance. This method ensures accuracy and promptness of the examination, possibility of real-time monitoring of the procedure and access to all locations within the breast and axilla, relatively low cost of the procedure and no exposure to ionising radiation. However, in course of diagnostics of microcalcifications it is recommended to perform a biopsy under mammographic guidance; it is a so called stereotactic biopsy.

Fine-needle aspiration biopsy (FNAB) is the least invasive method. The material is sectioned by a thin needle. The examination lasts only a few minutes and can be done in a doctor’s surgery. You don't need any anaesthesia. Due to quick BAC technical treatment, the diagnosis is fast and reduces the level of anxiety of the patient. BAC however, allows to evaluate excised cells only, you cannot evaluate the structure of the tissue. Core needle biopsy (CNB) is the most frequently performed type of biopsy. This is minimally invasive technique and usually requires local anaesthesia. To guarantee the appropriate quality of the examination, the doctor should excise an appropriate number of tissue fragments and make sure the biopsy needle goes through the lesion.

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