Breast biopsy

"The Clinic has a state-of-the-art digital mammograph that performs a three-dimensional study of the breast, allowing for greater diagnostic accuracy".

DR. LUIS PINA INSAUSTI
RADIOLOGIST. MAMMARY PATHOLOGY AREA

What is a breast biopsy?

A breast biopsy is a diagnostic test that involves the removal of all or part of a tissue sample for examination under a microscope by a pathologist. It is performed using imaging techniques (ultrasound, stereotaxy or MRI).

Breast biopsy is performed when cytology is not sufficient to characterize the alteration and a larger sample of tissue is needed for analysis. The sample will be fixed, stained and cut for the pathologist to study.

This procedure is called histology, and requires the use of a thicker needle to obtain more sample.

Guided Biopsy

To guide us through the procedure, the three usual breast imaging techniques are used (ultrasound, stereotaxy and MRI). Ultrasound is preferable for its speed and accuracy, as it offers real-time imaging, but for lesions not visible by that technique, the other two can be used.

The biopsy lasts 20-45 minutes depending on the technique. Only very occasionally and due to multiple causes, the sample may not be diagnostic.

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When is a breast biopsy indicated?

During the course of your medical study, some of the imaging tests (mammography, ultrasound, MRI...) may have shown some type of alteration of an unknown nature.

Most of the lesions detected (70%) are benign, but may be indistinguishable from breast cancer with imaging techniques alone. Therefore, it is justified to perform a biopsy and clarify definitively the nature of the lesion.

Diseases in which breast biopsy is requested:

Do you have any of these diseases?

You may need to have a breast biopsy

How is a breast biopsy performed?

Performing the breast biopsy

No preparation or fasting is required. Neither is any type of admission or special aftercare required.

The duration of the test is extremely short (about five minutes or less) and the tolerance is excellent. In fact, it is not usually necessary to administer analgesics after the puncture, in most cases.

Breast microbiopsy techniques

Currently there are other forms of biopsy ("microbiopsy") that allow obtaining enough material to reach a diagnosis, avoiding in many cases discomfort and unnecessary expenses.

For this reason, these techniques have been developed and have demonstrated their usefulness, with the advantages of being able to be performed under local anesthesia, in an ambultary regime, with the absence or minimum of scars and the consequent economic and time savings, if compared to surgical biopsy.

There are three types of technique:

  • Tru-cut biopsy: the needle has a caliber of about 2-3 mm. and is connected to an automatic gun, allowing the obtaining of a fragment of tissue. It finds its main indication in all types of breast nodules.
  • Vacuum-assisted biopsy: these systems are an evolution of the Trucut system, as the needle is of a larger calibre and connected to an aspiration system, so that better samples are obtained with a single puncture. They are mainly used in cases of microcalcifications.
  • Percutaneous excisional biopsy: these are biopsy cannulas that allow the removal of lesions of up to 20 mm in diameter in a single block. Its best indication is the distortions of the mammary architecture with undetermined previous result.

Preparing for breast biopsy

  • You should not take drugs that may predispose you to bleeding (anti-inflammatory, anticoagulants...) You will be asked before the procedure.
  • Let us know if you have any coagulation problems. However, coagulation tests will be performed before the procedure.
  • To reduce the risk of bleeding, you should fast and rest with compression on the puncture site for about four hours after the test is performed.
  • The skin is cleaned with an iodine solution to eradicate the bacteria living on it. Sterile, disposable materials (gloves, sterile needles) are used.
  • The position of the needle is followed to provide maximum diagnostic accuracy.

Possible complications of breast biopsy

  • Bleeding: There is a small risk, which is directly proportional to the size of the needle used, so the risk of bleeding from FAPP is very low (unless there is a coagulation disorder) and this risk is slightly increased when thicker needles are used, but it is still a rare complication. It also depends on the area to be punctured, with liver biopsies being associated with a higher risk of bleeding because of their rich vascularization. In most cases the bleeding is very limited and does not require specific monitoring after the procedure.
  • There is a theoretical risk of infection, but it is very rare if sterility measures are met.

In case you have persistent pain that does not disappear after standard medication, shortness of breath, weakness, numbness, fever or chills, you should consult your doctor.

Where do we do it?

IN NAVARRE AND MADRID

The Breast Pathology Area
of the Clínica Universidad de Navarra

The Clinic is the most technologically advanced private hospital in Spain in a single center. For this reason, the Breast Pathology Area is able to facilitate diagnosis 24 hours after performing the tests and begin treatment in approximately 48 hours.

Our nursing staff is specialized in breast pathology and performs patient education, telephone follow-up and advice, before and after surgery.

What diseases do we treat?

  • Breast Cancer
  • Inflammatory diseases of the breast
  • Benign tumors: fibrocystic mastopathy, breast fibroadenoma, etc.
  • Risk lesions that require vigilance
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Why at the Clinica?

  • Prestigious professionals who are international references.
  • Speed in the diagnosis and treatment of breast problems.
  • Specialized nursing for the best care of our patients.