Breast Biopsy Options

A tissue biopsy to diagnose breast cancer is part of the main investigation when an unusual breast lump is detected. A breast biopsy removes a small sample of breast tissue and is examined under a microscope to check for breast cancer. The approach to obtaining a breast biopsy has changed significantly over the years. Previously the only way to obtain a diagnosis of breast cancer is through a open surgical biopsy. However, now with better techniques and investigative tools, open excision biopsies has been replaced with preoperative diagnostic image guided biopsies.

There are several ways to do a breast biopsy:

Fine Needle Aspiration Biopsy (FNAC)

A syringe and thin needle is used to draw the fluid or cellular material from the breast lump . FNAC only examined the cells (cytology) and does not allow for more accurate diagnosis. It is painless with local anaesthesia and the accuracy of the report is minimal

Core biopsy / Trucut biopsy

A larger bore needle from a string-loaded biopsy gun is used to remove a small piece of breast tissue. The procedure is done under local anaesthesia where a few samples are taken for analysis. The histolopathological diagnosis is highly accurate with a bigger piece of tissue taken. It is often done under ultrasound guidance for better diagnostic value.

Breast biopsy is a safe procedure and will NOT cause cancer to spread.

Open Surgical Biopsy

This is an open surgical biopsy done under general anesthesia where the entire lump is removed and wound closed up. There will be an incision scar and the diagnosis is most accurate. However, a second surgery may be needed if the lump is confirmed malignant.

US guided hook wire localization and excision biopsy for impalpable lump

When an impalpable lump is identified under ultrasound image, a hook wire is placed and the lump is excised or biopsied under US guidance.

Stereotactic Hook wire localization biopsy or excision biopsy

For suspicious microcalcifications found on mammography (MMG), stereotactic core biopsy of the lesions can be carried out. In some cases, hook wires are inserted and suspicious area with microcalcification is excised via open surgery.

Vacuum assisted breast biopsy (VABB) / Mammotome breast biopsy

This is suitable for small benign lumps that can be removed via a “key hole” incision without going through an open incision scar. A small hollow probe is inserted into the breast and the lump is removed in small strips of tissue using a vacuum and rotating blade until the whole lump is removed entirely.