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Breast Core Biopsy. By Dr. Rania Zakaria Lecturer of Pathology Faculty of Medicine - Benha University. Fine needle aspiration biopsy. Fine needle aspiration is a quick and less invasive technique.
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Breast Core Biopsy By Dr. RaniaZakaria Lecturer of Pathology Faculty of Medicine - Benha University
Fine needle aspiration biopsy • Fine needle aspiration is a quick and less invasive technique. • However, it is difficult to be interpreted as the cells collected by fine needle appears under microscope as a disorganized jumble. • It is not possible to distinguish insitu and invasive tumors on the basis of fine needle aspiration biopsy alone.
Core Biopsy Definition • A core biopsy is a procedure where a needle is passed through the skin to take a sample of tissue from a mass or lump. • The tissue is then examined microscopically for any abnormalities.
Core Biopsy Core biopsy may be performed when a suspicious lump is found, for example a breast lump or enlarged lymph node or if abnormality is detected on an imaging test such as x-ray, ultrasound or mammography.
Core Biopsy Core biopsy is a more invasive procedure than fine needle aspiration biopsy, as it involves a local anaesthetic. However, it is quicker and less invasive than a surgical biopsy. In some cases, the result of a core biopsy will prevent the need for surgery to take place.
How is a Core Biopsy Done? • A core biopsy is a simple procedure to collect a sample of cells from a mass to be examined microscopically. • No special preparation is required, though the patient is informed not to use any powder (such as talcum powder), lotion, creams, perfumes or deodorants near the area to be sampled
How is a Core Biopsy Done? • Core biopsy is performed with the use of local anaethetic to numb the area where the needle is inserted. A small incision is made in the skin over the lump, and a specially-designed hollow needle is inserted through the incision. When the tip of the needle is in the area to be examined, it collect a sample of the cells that are present. • The needle is then withdrawn, and the sample is extracted. This may be repeated, until an adequate sample has been collected.
How is a Core Biopsy Done? • In some cases, the lump or the mass from which the cells are to be taken is not easily felt through the skin. • In these cases, the radiologist, surgeon or pathologist collecting the sample may use ultrasound, where the needle can be seen on the ultrasound monitor and guided to the area, or mammography which use 2 mammograms at different angles and a computer to locate the correct area. This may make the procedure take a little longer.
How is a Core Biopsy Done? • Once the test is completed, a small dressing or some tape will be placed over the biopsy site which may be removed the next day.
Results of a Core Biopsy • The samples taken are examined microscopically. A detailed report will then be provided about the type of cells that were seen, including any suggestion that the cells might be cancer. • It is important to remember that having a lump or mass does not necessarily mean that it is cancerous, many core biopsies reveal that suspicious lumps or masses are benign.
Results of a Core Biopsy • Aspirate samples may be described as one of the following types: - Inadequate: The sample taken was not adequate to exclude or confirm a diagnosis of cancer. - Benign: There are no cancerous cells present. - Atypical/ Intermediate, suspicious of malignancy: Some cells appear abnormal but are not definitely malignant so a surgical biopsy is required for proper diagnosis. - Malignant: show malignant criteria (loss of polarity, pleomorphism, increased nucleocytoplasmic ratio, hyperchromasia, abnormal mitosis, etc.)
How effective are core biopsies? • Core biopsy is an effective tool in evaluating and diagnosing suspect lumps or masses. • Allow quick diagnosis. • Core biopsy is also very good at determining whether a lump is benign, potentially avoiding the need for surgery.
How effective are core biopsies? • Core biopsy do require some expertise to perform and interpret. • To insure that an accurate result is achieved, it is important that the radiologist, surgeon, pathologist and oncologist who perform the procedure has experience in core biopsy.
Benefits of a core biopsy • Core biopsy is relatively quick and effective for determining the status of suspect tissue. • Core biopsy are particularly useful for investigating abnormalities detected on imaging tests (as x-ray). It is the investigation of choice when breast microcalcification is seen on mammography.
Benefits of a core biopsy • Also, because the needle used is large enough, it take a slice of tissue good for interpretation and distinguishing between some types of precancerous diseases and malignant diseases (such as DCIS and invasive ductal carcinoma). • Compared to surgical biopsy, core biopsy involves little possibility of scaring, infection or pain, and has a significantly shorter recovery period.
Risks of a core biopsy • There are generally no complications with this procedure, though patient may experience some tenderness or bruising over the needle insertion site. • Risks of core biopsy include: - Bleeding, swelling, fever or pain (rare). - Core biopsy may leave a very small, fine scar, which usually fades with time.
Risks of a core biopsy • Risks of core biopsy include: • The possibility that malignant cells present could be trailed into unaffected tissue as the needle is removed which is rare when the test is performed by skilled practitioner.
