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A breast biopsy is a diagnostic method that allows you to determine the nature of atypical cells. The procedure is indicated when non-invasive research methods such as mammography or ultrasound are ineffective. The main goal of a breast biopsy is to rule out or confirm cancer.
Biopsy indications
A woman can turn to a mammologist if self-palpation of the breast reveals seals and tangible neoplasms. Other symptoms that require an urgent visit to a specialist are pain and discomfort, the appearance of age spots on the skin, a change in the shape and color of the nipple, areola, the release of liquids from the nipples that are not associated with pregnancy or lactation, the appearance of ulcers, scaly spots, and more. Initially, a biopsy may be prescribed for accurate morphological identification of neoplasm cells. If the patient has already been diagnosed with cancer, the goals of the biopsy may change – for example, the analysis is carried out in order to determine the exact boundaries of the tumor.
In this case, punctures are performed in several places at once. This technique is effective if it is not possible to see the tumor using other research methods.
How to prepare for a biopsy
A breast biopsy requires some preparation. First of all, 3-5 days before the procedure, the patient should refuse to take medications that help reduce blood clotting. In the event that this condition is not feasible, it is imperative to inform the specialist performing cell sampling.
In addition, the patient should inform her attending physician about the presence of sensitivity to certain groups of drugs, about cardiac pathologies and the installed pacemaker, pregnancy. On the day of the procedure, it is forbidden to apply any cosmetics to the chest, abdomen and armpits. The biopsy is performed using drugs for local anesthesia. In some cases, these funds can provoke a deterioration in well-being, so patients are advised to come to the study accompanied by persons who can take them home after the procedure.
How is the study of cells
The sample obtained during sampling is dissected into thin plates. If the resulting tissue is contaminated with blood or other biomaterials, it is initially washed in saline. In order to prevent changes in the structure of cells under the influence of the external environment, the tissue is stabilized with a 10% formaldehyde solution.
To study atypical cells, tissue is examined under a binocular loupe or microscope. A specialist under magnification has the opportunity to see the structure of the tissue, the presence of seals and necrosis, the presence of psammoma and vitreous bodies. This is followed by the study of the neoplasm cell itself – its shape, size. A characteristic feature of tumor cells is their large size and the presence of two or more nuclei. By comparing all the data obtained, the histologist can draw a conclusion about the nature of the neoplasm. Based on this conclusion, the attending physician establishes the final diagnosis with the determination of further therapy.
Histological results can be of several types:
- incomplete – as a result of a biopsy, too little tissue was obtained or the histologist cannot issue a conclusion due to the ambiguity of the results;
- normal – during the histological examination of tissues, no abnormalities were found;
- benign – the presence of a neoplasm is confirmed, but its benign character is established;
- non-cancerous – abnormal cells are not a tumor. Most often in this case we are talking about a cyst or mastitis;
- malignant – the diagnosis of cancer is confirmed.
Types of breast biopsy
Fine-needle aspiration biopsy is a research method that is simple and fast. A thin hollow needle is inserted into the patient’s body and cells are drawn into the cavity under the influence of back pressure.
Fine-needle puncture biopsy – the technique is used when it is necessary to obtain a sufficiently large amount of biomaterial for histological examination, or, if necessary, to determine the boundaries of the neoplasm.
Stereotactic biopsy – thin or thick hollow needles are used to collect cells. The same needle is inserted into different parts of the breast to determine the type of neoplasm located in the deep layers. In this case, strict control of the insertion of the instrument into the body is necessary, so the procedure is performed using ultrasound machines and a modern mammograph.
A trephine biopsy is a surgical operation during which the tissues of the neoplasm are partially or completely excised.
To take the material, a Palinka needle is used – a special tool, which is a rod with a cutter, equipped with a hollow tube with a stylet. After the incision of superficial tissues is made, the needle is inserted directly until direct contact with the tissue under study, the biomaterial fills the flexible hollow tube. Usually several punctures are required. This technique is the most informative, but it is associated with a high risk of postoperative complications, therefore, it is prescribed only when other research methods do not allow an accurate diagnosis.
Possible complications
Only when cells are taken with a thin needle, anesthesia is not used – such a diagnosis is associated with minimal pain. In all other cases, it is necessary to use local or general anesthesia, which can cause headaches, nausea, and loss of consciousness. Symptoms usually go away on their own after 1-3 hours.
At the puncture site, the skin may turn red, painful swelling or swelling may appear. In some cases, bleeding occurs, there is an increase in body temperature. Such symptoms serve as a reason for contacting a specialist.
In most cases, a breast biopsy is a procedure associated with minimal discomfort. But it makes it possible to diagnose the disease at an early stage – when it responds well to treatment.