US GUIDED BREAST BIOPSY

An ultrasound guided breast biopsy is a safe, highly accurate, and minimally invasive diagnostic procedure. At Cadabams Diagnostics, our expert radiologists use this technique to obtain a small sample of tissue from a breast abnormality, such as a lump, mass, or area of concern that was identified on a previous imaging test like a mammogram or breast ultrasound.

The primary purpose is to allow a pathologist to analyze the tissue under a microscope and provide a definitive diagnosis. This procedure is performed using real-time ultrasound imaging to ensure the utmost precision, making it a cornerstone of modern breast health diagnostics. It helps answer critical questions and guides your doctor in planning the most appropriate next steps for your care.

What is an Ultrasound Guided Breast Biopsy?

In simple terms, an ultrasound guided breast biopsy uses high-frequency sound waves to create live, detailed images of your breast tissue. This technology, similar to what's used during pregnancy, is completely radiation-free. The live image on the monitor acts as a roadmap, allowing the radiologist to see the exact location of the abnormality.

Using this visual guidance, the radiologist carefully directs a special, thin, hollow needle directly to the target area to collect several small tissue samples. This distinguishes it from other tests:

• Mammogram: A mammogram is an X-ray imaging test used for screening and diagnosis; it does not collect a tissue sample.
• Surgical Biopsy: A surgical biopsy is a more invasive procedure that requires a larger incision and is performed in an operating room, often under general anesthesia.

The most common method for this procedure is an ultrasound guided core needle biopsy of the breast, which provides a substantial tissue sample for a comprehensive and accurate analysis.

Types of Ultrasound Guided Breast Biopsy

While the term covers a few techniques, the vast majority of procedures performed are Core Needle Biopsies (CNB).

• Core Needle Biopsy (CNB): This is the standard and most common type of ultrasound guided breast biopsy. It uses a slightly larger, hollow needle to extract several small, cylinder-shaped "cores" of tissue from the abnormal area. This method is highly effective because it provides enough intact tissue for the pathologist to evaluate the cell structure, which is crucial for an accurate diagnosis of conditions like breast cancer.

• Fine Needle Aspiration (FNA): Less commonly used for diagnosing solid masses, FNA uses a much thinner needle to draw out fluid or clusters of cells. It is often used to drain a painful cyst or to check if a lump is solid or fluid-filled. While less invasive, it provides less diagnostic information than a CNB because it collects individual cells rather than a complete tissue sample.

During the procedure, our radiologist focuses on several key parameters to ensure accuracy and a successful biopsy:

• Location of the Lesion: The precise location, depth, and orientation of the abnormality within the breast are identified and documented.
• Size & Shape: The radiologist measures the exact dimensions of the lesion and notes its shape (e.g., round, oval, irregular).
• Ultrasound Characteristics: The appearance of the lesion on the ultrasound is carefully evaluated. This includes whether it is solid or cystic (fluid-filled), and whether its borders are smooth and well-defined or irregular.
• Needle Placement: The most critical parameter is the visual confirmation, via the live ultrasound image, that the tip of the biopsy needle is correctly positioned within the target lesion before each sample is taken.

There are several vital reasons why your doctor will recommend this test:

• To Get a Definitive Diagnosis: This is the primary reason. It determines with high certainty whether a breast lump, mass, or abnormality is benign (non-cancerous) or malignant (cancerous).
• To Investigate Suspicious Findings: It serves as the logical next step after a mammogram or ultrasound shows an area of concern that needs clarification. [Link to: Breast Ultrasound Page]
• To Avoid Unnecessary Surgery: In many cases, the biopsy will show a benign condition, providing peace of mind and preventing a more invasive surgical procedure.
• To Guide Treatment Planning: If cancer is detected, the tissue sample provides crucial information about the type and characteristics of the cancer, which is essential for planning the most effective treatment.
• To Drain a Symptomatic Cyst: The procedure can be used to drain a large or painful breast cyst, providing immediate relief.

Types of Ultrasound Guided Breast Biopsy

While the term covers a few techniques, the vast majority of procedures performed are Core Needle Biopsies (CNB).

• Core Needle Biopsy (CNB): This is the standard and most common type of ultrasound guided breast biopsy. It uses a slightly larger, hollow needle to extract several small, cylinder-shaped "cores" of tissue from the abnormal area. This method is highly effective because it provides enough intact tissue for the pathologist to evaluate the cell structure, which is crucial for an accurate diagnosis of conditions like breast cancer.

• Fine Needle Aspiration (FNA): Less commonly used for diagnosing solid masses, FNA uses a much thinner needle to draw out fluid or clusters of cells. It is often used to drain a painful cyst or to check if a lump is solid or fluid-filled. While less invasive, it provides less diagnostic information than a CNB because it collects individual cells rather than a complete tissue sample.

Benefits of Taking the Test

Choosing an ultrasound guided breast biopsy at Cadabams Diagnostics offers significant advantages for patients:

• High Accuracy: The use of real-time ultrasound guidance allows our radiologists to target the abnormality with exceptional precision, leading to a highly reliable diagnosis.
• Minimally Invasive: The procedure is performed through a tiny skin nick that is so small it doesn't require stitches and leaves little to no scarring.
• Quick and Convenient: The entire appointment is typically completed in under an hour, with the biopsy itself taking only about 15-20 minutes.
• Fast Recovery: Most patients can return to their normal, non-strenuous activities the very next day.
• No Radiation Exposure: Ultrasound uses sound waves, not ionizing radiation, making it an extremely safe imaging modality.

Illnesses Diagnosed with Breast Biopsy Scan

This procedure is essential for accurately diagnosing a wide spectrum of breast conditions, both benign and malignant.

Malignant Conditions (Breast Cancer)

• Invasive Ductal Carcinoma (IDC): The most common type of breast cancer.
• Ductal Carcinoma In Situ (DCIS): A non-invasive or pre-invasive form of breast cancer.
• Invasive Lobular Carcinoma (ILC): Another type of invasive breast cancer.
• Other less common forms of breast cancer.

Benign (Non-Cancerous) Conditions

• Fibroadenomas: Common, solid, non-cancerous breast tumours.
• Breast Cysts: Fluid-filled sacs within the breast.
• Fibrocystic Changes: Lumpy or rope-like changes in breast tissue.
• Fat Necrosis: Damaged or dead fatty tissue that can form a lump.
• Benign Tumours: Such as phyllodes tumours or papillomas.
• Inflammation or Infection: Such as mastitis.

Preparation is simple and straightforward.

• Clothing: Please wear a comfortable, loose-fitting, two-piece outfit (e.g., a top and pants/skirt). You will be asked to undress from the waist up and will be given a gown to wear.
• Medications: It is crucial to inform our staff about all medications you are taking, especially blood thinners like aspirin, warfarin (Coumadin), clopidogrel (Plavix), or other anticoagulants. Your doctor may advise you to stop taking these for a few days before the procedure to minimize bleeding risk.
• Food and Drink: There are no dietary restrictions. You can eat and drink as you normally would before your appointment.

Pre-requisites

• A doctor's referral for the biopsy is required.
• Please bring any prior imaging reports and images (mammograms, ultrasounds) with you to your appointment. This allows our radiologist ([Link to: Meet Our Radiologists/Specialists Page]) to review your history and plan the procedure effectively.

Best Time to Take the Ultrasound Guided Breast Biopsy

This procedure is not affected by your menstrual cycle and can be scheduled at any time that is convenient for you.

Eligibility

Most patients with a suspicious breast lesion identified on an ultrasound or mammogram are eligible for the procedure. However, it is essential that you discuss your full medical history with your doctor and our radiology team. Be sure to mention if you have a severe bleeding disorder or any known allergies, particularly to local anaesthetics like lidocaine, adhesives, or skin antiseptics.

Procedure for Taking an Ultrasound Guided Breast Biopsy

Knowing the breast biopsy procedure steps can help you feel more comfortable and prepared for your appointment. Here is what you can expect at Cadabams Diagnostics:

1. Preparation: You will change into a gown and be asked to lie comfortably on your back or slightly on your side on the examination table.
2. Positioning & Scanning: The radiologist will apply a warm, water-based gel to your breast. They will then use the handheld ultrasound probe (transducer) to scan the area and precisely locate the abnormality on the monitor.
3. Numbing the Area: Once the target is located, the skin will be thoroughly cleaned with an antiseptic solution. The radiologist will then inject a local anaesthetic into the skin and deeper tissue using a very fine needle. You may feel a brief sting or burning sensation, similar to dental numbing, which will quickly subside as the area becomes numb.
4. Incision: A very small nick (about 2-3 mm) is made in the numbed skin with a scalpel. This allows the biopsy needle to pass through easily and does not require stitches.
5. Sample Collection: The radiologist will insert the core biopsy needle through the incision. Watching the live ultrasound image, they will guide the needle directly into the abnormality. You will hear a loud 'click' or 'popping' sound as the automated device quickly moves forward to capture a tissue sample. You may feel some pressure, but you should not feel sharp pain. Several samples (typically 3-5) are taken through the same incision to ensure a comprehensive diagnosis.
6. Completion and Bandaging: After enough samples have been collected, the needle is removed. Firm pressure will be applied to the site for several minutes to stop any bleeding. A small sterile bandage or steri-strips will be applied over the incision.

Caution Before Taking the Test

For your safety, it is absolutely essential that you inform the radiologist and technologist before the procedure if you:

• Are pregnant or think you might be pregnant.
• Are taking any blood-thinning medications or supplements (e.g., aspirin, warfarin, fish oil).
• Have any known allergies, especially to local anaesthetics (lidocaine), tape/adhesives, or antiseptic solutions.