Having a biopsy is the next stage once an initial breast screening by mammogram, genetic testing, MRI, Ultrasound or PT/CET scan has occurred. It will only happen where there are possible signs of breast cancer.
A sample of cells (either tissue or fluid) is taken from your breast and tested to see if it’s cancerous. You may also need a sample from your lymph nodes.
In the general population (read western) only 20 per cent of biopsies are found to be cancerous. This is likely to be much higher for people of African heritage given a majority of Black Breast Cancer is already advanced at the time of diagnosis.
THERE ARE FOUR TYPES OF BIOPSIES:
FINE NEEDLE ASPIRATION (FNA)
A fine needle is often used on swellings or lumps located just under the skin. Maybe a lump is felt during a doctor’s examination, or because of a breast screening result. A fine needle aspiration might also be used for,
Swollen lymph nodes
Solid lumps (nodules or masses)
Fluid-fill lumps (cysts)
This biopsy is a simple and quick procedure. Local anaesthetic is not usually required as the procedure should not be painful. The needle has a hollow interior and is much finer than a regular needle used to draw blood though it might feel like you’re having a blood test.
The same will be examined by a pathologist under a microscope before a detailed report is made about the type of cells seen. This report is extremely important to you because it really will determine what decisions you make about your treatment going forward. If you don’t understand what the report says because of the medical terms, make your doctor / oncologist explain it to you.
The difference between a Core and a FNA needle is the depth from which the sample is taken. It’s more invasive. A small incision (cut) in the skin is made. A large needle is then passed through this incision and several narrow samples of the tissue to be investigated such as a lump taken. Core biopsy is done under local anaesthetic and sometimes you’ll be asked to lie on your front while this is done.
The procedure usually takes between 30 minutes and 1 hour. You may need a small dressing afterwards and you may be left with a small scar from the incision.
A Stereotactic Core Biopsy
It’s more complex if ‘the area’ can only be seen by mammogram because then the core needle is lead by what is seen on a computer screen.
This helps to locate the exact position of the area to be biopsied. Images of the breast are taken from two different angles to help guide the needle to the precise location.
You will be given a local anaesthetic and will be in a sitting position or lying down on a specialised examination couch. It may feel a little uncomfortable as the mammogram plates are pressed onto the breast throughout.
Whichever way the core biopsy is done, a small dressing or plaster will usually be applied, and you’ll be asked to keep this on for a day or so afterwards.
Once the local anaesthetic wears off, your breast may ache and may be bruised for the next few days or weeks. You can take pain relief if the area is tender or painful. You’ll be given more information about this before you leave the clinic.
A special instrument punches a small hole in the skin to obtain a skin sample to investigate a skin condition. This may be done when there is a change to the skin of the breast or nipple. You’ll be given a local anaesthetic before a tiny cutting device is used to take the sample. As with a core biopsy, usually you’ll be asked to wear a small dressing or plaster afterwards.
For this type of biopsy, surgery is used to remove all or part of a lump so it can be checked to see if there are cancer cells in it.
THERE ARE 2 TYPES OF SURGICAL BIOPSIES:
An incised biopsy which removes only part of the abnormal area.
An excised biopsy which removes the entire tumor or abnormal area plus maybe a bit more around the edges.
A surgical biopsy is not likely to be done in the doctor’s office but in a hospital’s outpatient department. You’ll be given a local anaesthetic with intravenous sedation. (This means you’re awake, but your breast is numbed, and you’re given medicine to make you drowsy.)
Another option is to have the biopsy done under general aesthesia where it knocks you out completely. I took the general.
The skin of the breast is cut, and the doctor removes the suspicious area. You often need stitches after a surgical biopsy, and pressure may be applied for a short time to help limit bleeding. The area is then covered with a sterile dressing. Honestly, I came out feeling fine and went home that same evening. I marvelled at doctors and technology. I had a lumpectomy and 14 lymph nodes removed.
WAITING FOR THE RESULTS
The initial biopsy is one by either a fine or core needle and that’s what confirms you have or haven’t got breast cancer. That period can feel like a very long time. I think I waited a week though I was mentally prepared for the result. I do regret going to that meeting alone because I still didn’t hear most of the information, they gave me. I was too busy ‘handling’ it. I would definitely recommend you take someone with you whether you feel prepared or not.