If you notice any lumps or unusual changes in your breasts, you should see a doctor. Try to pinpoint the area accurately as this will assist your doctor with the examination. Your doctor may advise you to undergo some tests so that a definite diagnosis can be made. These tests may include one or more of the following:
If you have breast symptoms, you may need to have a mammogram to help with the diagnosis. The mammogram checks for the presence and position of the abnormality. To do this, more detailed x-rays may be needed as compared to those taken for a mammogram screening. Sometimes a lump that can be felt is not seen on a mammogram. Other tests are often necessary to determine whether the lump is cancerous or not. If you have recently had a mammogram, remember to bring with you the x-rays (and report if available) when you see the specialist.
Breast ultrasound is the use of high frequency sound waves to produce an image of breast tissue. Ultrasound does not use radiation. The doctor or radiographer does the scanning. This test can differentiate a fluid-filled cyst from a solid lump.
Magnetic Resonance lmaging (MRI)
A diagnostic test that uses magnetic fields to capture multiple images of the breast tissues. These images are combined to create a picture of the inside of the breast. This test does not use radiation and is completely painless.
Fine Needle Aspiration (FNA)
For this test, your doctor uses a syringe with a very fine needle to withdraw fluid or cells from a breast lump. This can be uncomfortable but is usually not painful. If the lump is just a cyst, withdrawing fluid in this manner will usually make the cyst disappear. However, if the lump is solid, your doctor may use this procedure to withdraw some cells from it. The cells will then be sent to a laboratory for examination.
Core Needle Biopsy
This method obtains a few slivers of tissue from an area of abnormality with a wide bore needle. Local anaesthetic is used to numb the breast area first, followed by a small incision in the skin to allow easy insertion of the needle. If the abnormality cannot be felt easily, the procedure can be performed with ultrasound or x-ray guidance.
Large Core Needle Breast Biopsy (Mammotome®)
Mammotome® Breast Biopsy uses a vacuum-assisted device to obtain tissue samples from non-palpable lesions. Small samples of tissue are removed from the breast using a large bore needle which is guided precisely to the suspicious lesion via x-ray or ultrasound.
A small titanium clip (microclip) may be placed at the biopsy site to act as a location marker for future treatment. An x-ray is taken during post-biopsy to ensure proper clip placement.
This procedure is minimally invasive as compared to an open surgical biopsy. It is performed as a day surgery procedure. It has the ability to sample tiny abnormalities called microcalcifications, making early diagnosis of breast cancer possible. It is done under local anaesthetic and takes about 30 to 45 minutes to complete. The procedure is usually not painful but you may experience some discomfort.
An excision biopsy involves the surgical removal of a lump or sample of suspicious tissue for examination under a microscope to give a definite diagnosis. Sometimes, ultrasound or x-ray pictures are taken to insert a small thin wire to the abnormal spot in the breast. This wire is used to guide the surgeon to the right spot of abnormal lesion for removal. The technique is known as hook wire localisation biopsy.
Biopsies can be performed either under local or general anaesthetic, depending on the size and position of the lump. You can leave the hospital on the same day.
If you are unsure of how the biopsy will be done, you may want to ask the surgeon to explain how the procedure is done before you undergo it.
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