the Process of Breast Biopsy Surgery: A Comprehensive Guide

The process of breast biopsy surgery?

Hello:
1.
Outpatient Information: A mammogram revealed calcifications in the left breast, suspected to be malignant tissue.
The doctor recommends a three-day hospitalization for a biopsy (requiring general anesthesia), followed by pathological examination to confirm the diagnosis.

2.
Patient Profile: 56-year-old female, has given birth to four children, and breastfed for 48 months.

3.
Questions:
(1) What type of biopsy requires general anesthesia? (FNAC, CNB, or other biopsies?)
(2) What is the general process and requirements for this procedure?
Thank you sincerely for your response.

Best regards,
Juan Juan
August 5, 2006

Lin, 30~39 year old female. Ask Date: 2006/08/05

Dr. Lin Kecheng reply Surgery

Dear Ms.
Juan Juan,
I apologize for not responding promptly due to my recent business trips.
The biopsy procedure, which requires general anesthesia, is necessary to obtain sufficient tissue for diagnosis, and it is the most definitive step for accurate diagnosis.
Generally, Fine Needle Aspiration Cytology (FNAC) can be performed in an outpatient setting without anesthesia; however, the evidence for a definitive diagnosis is often insufficient, and most physicians use it only for preliminary examination.
Core Needle Biopsy (CNB) uses a larger needle to obtain more tissue, but it can be quite painful without anesthesia and may lead to hematoma formation.

A standard biopsy typically requires local anesthesia, but if the mass is larger or deeper, physicians often recommend general anesthesia.
Microcalcifications suspected of being malignant on mammography may be very small and may not be palpable during physical examination.
In such cases, the physician may perform localization before the biopsy by inserting a localization needle to confirm the calcification site, followed by a complete biopsy procedure to excise the suspected malignant tissue for laboratory analysis.
Although this process may be cumbersome, we should appreciate the physician's willingness to invest extra time in handling it, as this step is usually performed for very small suspicious lesions.
Having four children and breastfeeding generally lowers the risk of breast cancer; however, please avoid unnecessary hormone therapy.

Wishing you good health and happiness, and I apologize once again for the delayed response.

Reply Date: 2006/08/05

More Info

Understanding the process of breast biopsy surgery is crucial for patients who may be facing this procedure, especially when there are concerns about potential malignancies. In your case, the recommendation for a breast biopsy following a mammogram that indicated suspicious calcifications is a common and necessary step in diagnosing breast conditions.

Types of Breast Biopsy
1. Fine Needle Aspiration Cytology (FNAC): This is a minimally invasive procedure that uses a thin needle to extract a small sample of tissue or fluid from the breast. It is typically performed in an outpatient setting and does not require general anesthesia. However, FNAC may not provide sufficient tissue for a definitive diagnosis, especially in cases where malignancy is suspected.

2. Core Needle Biopsy (CNB): This method involves using a larger needle to obtain a core of tissue from the breast. CNB is more effective than FNAC in providing a larger sample for pathological examination. While it can be performed under local anesthesia, general anesthesia may be recommended if the lesion is deep or if the patient is particularly anxious.

3. Surgical Biopsy: This is a more invasive procedure where a surgeon removes a larger section of breast tissue. This is often done under general anesthesia, especially if the lesion is not easily accessible or if a larger sample is needed for diagnosis.

Given that your procedure requires general anesthesia, it is likely that you will undergo a surgical biopsy, which is the most comprehensive method for obtaining breast tissue for analysis.

The Surgical Process
The process of a breast biopsy surgery typically involves several key steps:
1. Preoperative Preparation: Before the surgery, you will undergo a thorough evaluation, including blood tests and imaging studies, to assess your overall health and the specific characteristics of the lesion.

2. Anesthesia: On the day of the surgery, you will be taken to the operating room where an anesthesiologist will administer general anesthesia. This ensures that you are completely unconscious and pain-free during the procedure.

3. Incision and Tissue Removal: The surgeon will make an incision in the breast, usually in an inconspicuous area. Using imaging guidance (such as ultrasound or mammography), the surgeon will locate the suspicious area and remove a portion of the tissue. The size of the incision and the amount of tissue removed will depend on the specific characteristics of the lesion.

4. Closure: After the tissue has been removed, the surgeon will close the incision with sutures or surgical adhesive. A sterile dressing will be applied to protect the area.

5. Postoperative Care: After the surgery, you will be monitored in a recovery area until the anesthesia wears off. You may experience some discomfort, swelling, or bruising, which can be managed with pain medication. Instructions will be provided regarding wound care and activity restrictions.

6. Pathological Examination: The tissue sample will be sent to a pathology lab for examination. The results typically take a few days to a week, and your doctor will discuss the findings with you.

Risks and Considerations
While breast biopsy surgeries are generally safe, there are potential risks involved, including:
- Infection: As with any surgical procedure, there is a risk of infection at the incision site.

- Bleeding: Some bleeding is normal, but excessive bleeding may require further intervention.

- Scarring: Depending on the size of the incision, there may be visible scarring after healing.

- Changes in Breast Appearance: Depending on the extent of the surgery, there may be changes in the shape or size of the breast.

Conclusion
In summary, the breast biopsy surgery you are facing is a critical step in diagnosing potential breast cancer. Understanding the types of biopsies, the surgical process, and the associated risks can help alleviate some anxiety surrounding the procedure. It is essential to maintain open communication with your healthcare team, who can provide personalized guidance and support throughout this process. If you have any further questions or concerns, do not hesitate to reach out to your medical provider for clarification and reassurance.

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