| The
Sam & Jennie Bennett Breast Care Center |
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Breast Biopsy Services |
Breast Cyst Aspiration of a known
cyst is a simple, inexpensive procedure which can be performed
in a matter of minutes, with minimal discomfort to the patient.
The recommendation of the Bennett Breast Care Center is to
only aspirate a symptomatic cyst that is painful or very large.
(The majority of breast cysts are left alone and often resolve
without aspiration). The fluid is tested for guiac (hidden
blood) and is not routinely sent to the laboratory for analysis.
The skin where the needle is inserted will be locally anesthetized
(frozen) with Novacaine. Aspirated cysts can reform (regrow)
and may have to be aspirated a second time.
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Fine needle
aspiration is a procedure similar to the aspiration of
cysts (fluid filled) but are performed on breast tumors (solid
on ultrasound). A very fine needle is inserted using a similar
technique to breast cyst but instead of withdrawing fluid,
tiny breast cells are withdrawn and sent for analysis to make
the diagnosis of a benign (fibroadenoma) or cancerous breast
tumor
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Core needle biopsy is a diagnostic
procedure that is highly accurate in identifying the presence of a malignant (cancerous)
tumor without having to undergo a surgical procedure. This
minimally invasive procedure is performed with a hand-held
needle that removes small tissue samples from the area. The
breast is locally anesthetized and is very well tolerated
by most women with minimal discomfort. Often the core needle
is guided into position with the use of ultrasound and can
be performed by either a surgeon or radiologist. The patient
leaves with a sterile-strip over the wound and an ice pack.
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Stereotactic needle biopsy is a minimally invasive, sophisticated technique for extremely
small lumps or calcium deposits that cannot be felt but are
detected on mammography. This method combines mammogram and
computer technology to locate and withdraw cells for analysis.
The Bennett Breast Care Center has
been performing this procedure since 1998 and prior to that,
CMMC initiated the technique in the early 1990's. It
is highly accurate in diagnosing a variety of breast abnormalities
with little discomfort.
To perform this procedure, the patient lies face down on a
table that has an opening that allows the breast to be suspended.
The mammography unit along with the computer program, guide
the special needle into the proper biopsy position. Using
local anesthesia, a very small incision (does not require
stitches) is made and the special needle is inserted. The
needle retrieves enough breast tissue for the pathologist
to examine to determine if the lesion is malignant (cancer)
or benign (not cancer). Following the biopsy, an ice pack
and a small sterile strip are applied to the wound.
There are two ways to do a stereotactic needle biopsy and
both are performed at the center:
- Tru-cut- described above.
Most often used for a breast density found on mammogram.
- Mammatome (a vacuum assisted
device) - different from the Tru-cut in that a vacuum is
attached to the probe and the probe is rotated in a 360
degree fashion and tissue is obtained with each rotation
without having to withdraw or re-insert the probe during
the procedure. Most often used to biopsy micro-calcifications
(calcium deposits in the breast tissue) identified on mammogram.
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Needle Localization : Sometimes
very small lumps which are found on mammogram but
cannot be felt can be hard to locate and biopsy. In order
to target the exact location of such a small lump, a special
type of needle, with a fine hooked wire inside it, is guided
into place with the use of mammography. When the needle reaches
the exact site of the lump, the hooked wire is fixed into
the area. It is left in the lump until the patient is brought
into surgery to have it by an open, surgical incision. By
localizing the lesion, the physician is able to remove the
lump without removing a large amount of normal tissue.
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Sentinel Node Biopsy: There
are many factors that are important in treating a breast cancer
and one of them is to determine if any lymph nodes have tumor
in them. Traditionally, surgeons have removed most of the
lymph nodes in the axilla (arm pit). However, this procedure
can be associated with post-operative discomfort and arm swelling
know as lymphedema. A more recent technique called “sentinel
node biopsy” has been shown to determine if the cancer
has spread into the lymph nodes by taking just a few nodes
which lies closer to the original tumor. If the sentinel lymph
nodes are negative (no cancer found in them), then the axillary
lymph nodes removal is avoided. However, in selected cases,
the sentinel node biopsy may be followed by an Axillary Node
Dissection (removing the lymph nodes in the arm pit). Two
techniques are used in combination to identify the sentinel
nodes. First, about two to three hours prior to surgery, a
radioactive solution is injected into the breast skin near
the cancer. The surgeon will use a special probe during the
surgery to find the node(s) that pick up the radioactivity.
Secondly, during surgery an injection of a blue dye will be
given to aid in the detection of the sentinel node(s).
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Ductal Lavage (First Cyte): A
woman can know more now about their
individual breast cancer risk. Her doctor can tell whether
she is at high risk for breast cancer based on the risk factors
in her personal medical history and her family history. The
Breast Center is now offering Ductal Lavage as a way to examine
the cells inside a woman's breast to reveal whether there
are any abnormal changes in the breast. Knowing whether she
has abnormal cells in her breast can help a woman and her
doctor make decisions about ways to reduce her breast cancer
risk.
Ductal Lavage is only used with standard breast cancer detection
methods such as mammography, clinical exams, and breast self-exams
for women identified as high risk for breast cancer. Lavage
means “to rinse”. Ductal Lavage is a method of rinsing
the milk duct to obtain cells for analysis.
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