True cut biopsy of

breast

MANSOURA FACULTY OF MEDICINE

PATHOLOGY DEPARTMENT

By dr.ahmed elgayar

TOPICS

-introduction

-How to Prepare for the Test

-How the Test Will Feel

-procedure

-technique

-Laboratory examination

-advantages

-disadvantages

Biopsy

is the medical term for taking a sample of

tissue from the human body. For breast

means taking a small sample of cells or

tissue from your breast and looking at the

sample under a microscope. A specialist

doctor (a pathologist) examines these

samples and can see if they contain areas

of cancer.

How to Prepare for the Test

The health care provider will ask questions about your medical

history and perform a manual breast exam.

You must sign an informed consent form. If you are going to have

general anesthesia, you may be asked not to eat or drink anything for 8 - 12 hours before the test.

If you take medications (including aspirin or herbal medications), ask

your doctor whether you need to stop taking these before the

biopsy.

Tell your doctor if you may be pregnant before having an open

biopsy.

Do not wear lotion, perfume, powder, or deodorant underneath your arms or on your breasts.

Feeling after the test

After the test, the breast may be sore and

tender to the touch for several days. If a surgical

cut is made, your doctor may prescribe pain

medication.

You will probably go home the day of the

procedure.

Do not do any heavy lifting for 24 hours after the

biopsy. Do not take a shower for the first 24

hours.

Needle biopsy

commonest method of obtaining a biopsy (it is also called a core biopsy or True-Cut biopsy)

It removes a small cylinder (core) of

tissue (about 1/16- to 1/8-inch in

diameter and ½-inch long) from a

breast abnormality. Several cores are

often removed

Palpable mass

Technique Typically it is done under local

anesthesia. .the lump steadied between thumb and forefinger

Skin infiltrated with 1ml per cent of lignocaine ..5ml incision is made over lump

The needle introduced throw incision ..the obturator was thrust into limp and sheath advanced ..trapping tissue in the specimen notch

1 2

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Core needle biopsy for

nonpalpable masses

it will likely be done in a clinic or imaging center.

The health care provider will locate the

abnormal area with the help of ultrasound or a

special type of three-dimensional

mammography, called stereotactic

mammography

Core needle biopsy with

stereotactic mammography

, you lie on your stomach on a special table

and your breast fits through a hole in the

table –

health care provider will use a local

anesthetic to numb the area. Your breast will

be compressed like it is for a mammogram,

and several images will be taken. These

images help the provider guide the biopsy

device to the suspicious area in the breast. A

needle in the device removes tissue samples.

Laboratory examination

Specimen placed in 10 per cent buffed

Formalin .. the pathologist can see the cells in place within the piece of breast tissue that has been removed. So it is possible, using this test, to distinguish a non invasive cancer (DCIS) from invasive breast cancer.

Core biopsy results

Your result may be described to you as one of the following:

normal breast tissue – B1

benign (not cancer) – B2

abnormal or uncertain but probably benign – B3

suspicious and possibly malignant (cancer) – B4

malignant (cancer) – B5.

B stands for ‘biopsy’.

Biopsy and surgery: Two-step or

one-step procedure

the two-step procedure). That woman and medical team prefer

to schedule further surgery, if needed, after the biopsy

The one-step procedure). in which the biopsy and

surgery are done during the same operation. If you are

going to have a one-step procedure, you will want to

know all of your treatment options beforehand because

you must make important choices before the one-step

procedure begins

Advantages

If breast cancer is found, the tissue removed during a core needle biopsy gives important information including:

Tumor type

Tumor grade

Hormone receptor status

This information helps you and your health care provider plan your treatment.

If the tissue sample is benign (not cancerous), surgery may be avoided. In some cases, however, even if the tissue sample is benign, an excisional biopsy (a surgical biopsy) may be needed to confirm the diagnosis.

Drawbacks of core needle biopsy

the needle can miss a tumor and take a sample

of normal tissue instead. This is most likely to

occur when the biopsy is done without the help

of stereotactic mammography or ultrasound.

biopsy will show that cancer does not exist

when in fact, it does. This is called a false

negative result and can delay diagnosis. For

nonpalpable masses