Breast cancer biopsy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2] Ammu Susheela, M.D. [3]
Overview
Breast biopsy the only definite way to diagnose breast cancer. Hence, every patient with a doubtful lesion in her/his breast should undergo a biopsy to evaluate the nature of the mass precisely. Nevertheless, a large number of biopsy samples taken from breast lumps are found to be benign.
Biopsy
- During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample. [1]
- A breast biopsy is the only definite way to diagnose breast cancer. Most biopsy samples taken from breast lumps are found to be benign (non-cancerous).
- The type of biopsy will depend on whether the lump can be felt (palpable) or not (non-palpable). Ultrasound or computed tomography (CT) scan may be used to guide the biopsy. The types of biopsy that may be used are:
- Fine needle aspiration (FNA)
- Core needle biopsy
- Stereotactic core needle biopsy
- Wire localization biopsy
- Surgical biopsy to remove part of or all of a breast lump or abnormal area
- A biopsy is also done if inflammatory breast cancer is suspected, often including a skin biopsy. A biopsy of the nipple is taken if the doctor suspects Paget disease of the nipple.
Lymph Node Biopsy
A lymph node lymph node A small, bean-shaped mass of lymphatic tissue along lymph vessels (tubes through which lymph fluid travels in the body). Lymph nodes store lymphocytes (a type of white blood cell that fights germs, foreign substances or cancer cells) and filters bacteria and foreign substances (including cancer cell biopsy removes lymph nodes during a surgical procedure so they can be examined under a microscope to find out if they contain cancer.
With breast cancer, lymph nodes from under the arm (axilla) are removed. Breast cancer cells can travel through the lymph system, and the first place they may spread is to these lymph nodes. The number of lymph nodes that have cancer helps to determine the stage stage A description of the extent of cancer in the body, including the size of the tumour, whether there are cancer cells in the lymph nodes and whether the disease has spread from its original site to other parts of the body. of breast cancer.
Axillary Lymph Node Dissection
Axillary lymph node dissection (ALND) is a surgical procedure to remove the lymph nodes under the arm.
- Most breast cancers require staging with ALND.
- Axillary lymph node dissection is the standard method of checking lymph nodes.
Sentinel Lymph Node Biopsy
- The sentinel node is the first lymph node in a chain or cluster of lymph nodes that receive lymph fluid from the area around a tumour. Cancer cells will most likely spread to these lymph nodes. Sentinel lymph node biopsy (SLNB) is the removal of the sentinel node so it can be examined to see if contains cancer cells.
- Sentinel lymph node biopsy may be offered to women with breast tumours smaller than 5 cm, and the axillary lymph nodes cannot be felt during an examination by the doctor.
- Sentinel lymph node biopsy may not be suitable for women:
- who had breast surgery or radiation therapy in the past
- with axillary lymph nodes the doctor can feel
- with locally advanced or advanced breast cancer (tumours greater than 5 cm in size)
- with tumours in more than one area in the breast (multifocal tumours)
- with metastatic breast cancer
- inflammatory breast cancer
- who have had breast reduction surgery, or have breast implants
Reference
- ↑ Breast cancer. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/breast/signs-and-symptoms/?region=on#ixzz3xScycfqv Accessed on January 16, 2016