Getting a Breast Biopsy: Why It Is Necessary

A breast biopsy can be an intimidating procedure for many. It is a definitive diagnostic procedure that involves taking a small sample of breast tissue or cells and examining them under a microscope by a pathologist. Unfortunately, if there is a suspicious finding in your breast, a biopsy is typically necessary to determine whether breast cancer is present or not. This examination provides a definitive answer about the presence of cancerous cells and helps determine the type and characteristics of the cancer, which are essential for developing an appropriate treatment plan. Facing the possibility of a biopsy can understandably be daunting. However, try to think of a biopsy as a step towards clarity and a source of necessary information for your healthcare team. With this, informed decisions can be made and any potential can be addressed early on. This proactive approach can also lead to more effective treatments and positive outcomes. A tissue biopsy is essential for several reasons:

• Confirming the diagnosis

A biopsy is the only way to definitively confirm whether a breast abnormality is cancerous or non-cancerous.

• Determining the type of breast cancer

There are different types of breast cancer, each with its own characteristics and treatment options. Biopsy results help identify the specific type of breast cancer, which guides the appropriate treatment approach.

• Staging the cancer

If breast cancer is confirmed, a tissue biopsy of an abnormal-appearing lymph node or an abnormal mass elsewhere in the body helps determine the stage of the cancer, which indicates the size of the tumor and whether it has spread to nearby lymph nodes or other parts of the body. Staging is essential for developing the best and most appropriate treatment plan.

• Treatment planning

Tissue biopsy results are crucial for determining the most appropriate treatment options based on the breast cancer type and stage. Treatment options may include surgery, radiation therapy, chemotherapy, hormone therapy, or targeted therapy.

• Prognosis and follow-up

Biopsy results, including cancer grade and Ki-67 level, when available, also provide information about the aggressiveness of the cancer, which can help predict the prognosis and plan for long-term follow-up and monitoring.

Fortunately, there are several types of breast biopsies used to obtain tissue samples for further examination and diagnosis, some of which are less extensive and invasive than others. The choice of biopsy method depends on factors such as the size and location of the breast abnormality, and individual patient factors.

Fine needle aspiration (FNA)

In an FNA biopsy, a thin needle is used to withdraw cells or fluid from the breast lump or abnormal area. This type of biopsy is often used for easily accessible lumps or cysts. FNA can help determine whether the lump is filled with fluid (benign) or solid (potentially cancerous). If an FNA is done and the patient is determined to have cancer, a core needle biopsy may need to be done to run additional tests to determine the cancer type. FNAs are also done to check if cancer is present in an enlarged lymph node.

Core needle biopsy

Core needle biopsy is a more extensive procedure that uses a larger needle to remove small tissue cores from the breast lump or suspicious area. It provides more tissue for analysis, making it more accurate in diagnosing breast cancer, including breast cancer type.

Surgical biopsy

Surgical biopsies involve the removal of a larger portion or the entire breast lump or abnormal area through a minor surgical procedure. There are two main types of surgical biopsies:

• Incisional biopsy

A portion of the lump is removed for examination.

• Excisional biopsy

The entire lump or abnormal area is removed for evaluation.

Lymph node biopsy

This biopsy is done to check whether cancer has spread to the nearby lymph nodes. It is often an FNA when the cancer is first diagnosed. A sentinel lymph node biopsy is when the sentinel lymph node, the first lymph node in the axilla or armpit to which cancer is likely to spread, is removed as part of surgery to remove the breast cancer.

The choice of biopsy method is determined by the healthcare provider based on individual circumstances. The goal is to obtain sufficient tissue samples to provide an accurate diagnosis while minimizing invasiveness and preserving breast function and appearance, as well as to minimize side-effects as a result of lymph node biopsy or removal. It is essential to discuss the biopsy procedure with your healthcare provider, understand the reasons for the recommended method, and ask them to address any concerns or questions you may have.

It's important to remember most breast abnormalities are not cancerous, and that most biopsies confirm benign (non-cancerous) conditions. Nonetheless, early cancer detection and accurate diagnosis are crucial for the timely and appropriate management of breast health concerns.

Remember that while a breast biopsy may be emotionally challenging, it is a vital step in obtaining an accurate diagnosis and determining the most appropriate treatment, if needed. It is crucial to acknowledge and address your feelings during this time. Surround yourself with supportive individuals, communicate openly with your healthcare team, and seek emotional support as needed. Breast cancer treatment and survivorship can also involve emotional aspects, and accessing appropriate support throughout your journey is essential for your overall well-being.