Breast Biopsy (Core Needle Biopsy, Fine Needle Aspiration) Test

Several diagnostic tests, including mammography and sonography, are used in the evaluation of breast masses. However, determination of whether a mass is malignant can only be made by obtaining a biopsy of the tissue

Test Description

Several diagnostic tests, including mammography and sonography, are used in the evaluation of breast masses. However, determination of whether a mass is malignant can only be made by obtaining a biopsy of the tissue. The tissue sample may be obtained via needle aspiration, by core biopsy, or by open incision. Breast biopsy is also used when there has been an observable change in the breast, such as skin ulceration or nipple drainage.
Breast Biopsy

THE EVIDENCE FOR PRACTICE

  • Large core imaging-guided breast biopsy is now the technique of choice in many institutions in the United States for biopsy of nonpalpable breast masses and abnormal calcifications. Either stereotactic or ultrasound-guided breast biopsy may be used for reliable diagnosis of breast cancer.
  • Normal Values
  • No abnormal cells or tissue present
  • Possible Meanings of Abnormal Values
  • Adenofibroma
  • Breast cancer
  • Fibrocystic disease
  • Inflammatory breast cancer
  • Intraductal papilloma
  • Mammary fat necrosis
  • Plasma cell mastitis

Interventions/Implications

Pretest

  • Explain to the patient the purpose of the test and the procedure to be done.
  • The biopsy is usually obtained using a local anesthetic, although general anesthesia is an option.
  • No fasting is required prior to the test, unless general anesthesia is to be used.
  • Obtain a signed informed consent.

Procedure

  • The patient is assisted to a supine position.
  • The skin is cleansed with an antiseptic and draped.
  • A local anesthetic is typically administered.
  • Gloves are worn throughout the procedure.

For a needle biopsy

  • For a fine needle aspiration biopsy, a needle is inserted into the mass, and a sample of tissue or fluid is aspirated into the syringe. A slide of the aspirate is made for cytology review. A sterile dressing is applied.
  • For a core needle biopsy, a very small incision is made and multiple samples are taken of the lesion using a commercially available device. This device is spring-loaded and allows the health-care provider to obtain samples which fill the needle core. The tissue specimens are placed in a specimen container with normal saline solution or formaldehyde. Steri-strips and a sterile pressure dressing are applied to the incision.

For an open biopsy

  • An incision is made in the breast to expose the mass.
  • The mass is then excised in entirety if it is smaller than 2 cm in size. If the mass is larger or appears malignant, a portion of the mass is excised.
  • The tissue specimen is placed in a specimen container with normal saline solution or formaldehyde.
  • If the mass appears malignant, the tissue sample is sent for frozen section and receptor assays. Do not place tissue for receptor assay testing in formaldehyde.
  • The wound is sutured, and a sterile dressing is applied.

Posttest

  • For biopsy under local anesthesia, check vital signs after the procedure. If general anesthesia was used, check vital signs every 15 minutes for the first hour, every 30 minutes for the next hour after that, every hour for 4 additional hours, and then every 4 hours.
  • Check the dressing for drainage.
  • Teach the patient to monitor the site and to notify the health-care provider if signs or symptoms of infection occur, such as drainage, redness, warmth, edema, pain at the site, or fever.
  • Administer analgesics as needed.
  • Provide emotional support as the patient awaits test results.
  • Report abnormal findings to the primary care provider.

Clinical Alerts

  • The finding of an abnormality in the breast and then waiting for test results can be quite anxiety-producing for the patient. If possible, schedule testing (mammography and sonography) on the same day and at a time when a speciallytrained radiologist would be available to perform a needle biopsy, if warranted.
  • Potential complication of the procedure is infection.

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Dr Lobby | DrLobby.com: Breast Biopsy (Core Needle Biopsy, Fine Needle Aspiration) Test
Breast Biopsy (Core Needle Biopsy, Fine Needle Aspiration) Test
Several diagnostic tests, including mammography and sonography, are used in the evaluation of breast masses. However, determination of whether a mass is malignant can only be made by obtaining a biopsy of the tissue
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