BREAST CANCER EXPERT FORUM
Differences in Biopsy Techniques?

Differences in Biopsy Techniques?

I'm 44 and very healthy overall--a bit overweight, but no surgeries or major illnesses.  Two weeks ago, during a routine mammo they found a density in my right breast.  I had a subsequent ultrasound done 3 days later which confirmed "something" and am now scheduled for a biopsy this Thursday. (I was not told the size of the mass but afterwards I looked at the screen which noted 3cm.)  There is a strong history of cancer in the family--Father died at 48 from stomach cancer, Grandmother (now deceased) and Mother had breast cancer so, of course, I'm trying not to be worried.

My question is--what are the differences in biopsies?  In my research I've seen reference to core needle biopsy, fine needle biopsy, steriostatic biopsy and asperation?  Is any one better than the other (ie, less instrusive, less painful, more accurate)?
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Dear Susan44:  There are several different types of biopsies and the best one for you is usually best determined by the surgeon, based on the mammogram, ultrasound and whether or not the lump can be felt.  A fine need aspiration (biopsy) is when a thin needle is inserted into a mass that can be felt.  It is done without the aid of a mammogram or ultrasound to guide the needle.  The cells from the needle are then submitted to pathology.  A stereotactic biopsy uses mammography or some other imaging guidance to be certain that the needle (or marker) is in the area of concern.  Then a core biopsy (sample using a large bore needle) or excisional biopsy (removal of the lump) can be done.  A core biopsy will take a sample of tissue using a large bore needle and the cells will be sent to pathology.  An excisional biopsy is marked with a very thin wire using mammography or other imaging guidance.  Then the lump is removed during an outpatient surgery and the entire specimen is sent to pathology.  The least invasive biopsies are those that use needles rather than incisions.  The most thorough biopsy is an excisional biopsy in which the entire lump is sent to pathology.  Each has its pros and cons as it relates to the individual situation.  You should discuss with the surgeon the options that will be best for you.
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From personal experience only .... the different types of biopsy you mentioned are basically the same ..... with some slight difference. The one you didn't mention was an excisional biopsy which would be done by a surgeon ..... the others are usually done in Radiology by the Radiologist. I would think that the Dr. that ordered your biopsy would have explained which type you are to have and the procedure in detail. If not you should demand a complete explanation. Best of Luck ........
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