Possibilities for Biopsy of Lesions in The Breast
At present there are many possibilities for biopsy of lesions in the breast, which are applied depending on the type of alteration is found and the options available in the center where the study is conducted (usually at the center has no time for all techniques, but a combination of them). The possibilities are:
FNA (fine-needle aspiration with fine needle)
Usually used in palpable lesions (which can be played while browsing the breast). Lets get a Pap test and see if there is malignant or not, but lets you know what kind of tumor it is. It’s less annoying for being a needle very finite, so is often used to be safer when you consider that the tumor is benign.
Needle biopsy tru-cut type
Allows for multi-cylinder of tissue for study, but requires local anesthesia and a small incision. With the material obtained can determine if the tumor is malignant and the type of tumor. Commonly used in easily palpable tumors and suspicious-looking to be cancerous.
Stereotactic Biopsy
It is used for lesions that can not be felt and have been diagnosed by imaging methods such as ultrasound or mammography fundamentally. Order to do was to put the patient with the breast in a position such that the breast be fixed without any movement, which is usually achieved by putting the patient lying face down on a bed with a hole through which the leaves the breast. Then with a bit of local anesthesia and radiology systems using the device is intended that the biopsy to the site suspect.
There are different biopsy devices that allow more or less tissue and remove the entire lesion or not. Sometimes it is the only surgical procedure that requires the patient. The worst of this procedure is uncomfortable posture and manipulations are performed with the breast, but avoid open biopsy, and complications are few and usually minor (mainly hematomas of varying size). The main use is in the studio when they are suspicious microcalcifications (up to 80% are benign lesions), but to be studied in order to diagnose early cancer cases.
Open biopsy
It is performed by making an incision in the skin and usually under local anesthesia. In lesions not palpable (when most often uses this type of biopsy) is placed previously in the radiology department a device called a harpoon, by the similarity in shape to the one used by fishermen, which allows the surgeon locate the lesion. It is usually unnecessary hospitalization and complications are also few and irrelevant, but the scar remains is greater than any of the other procedures.
As a rule, is usually used with less invasive procedure can be sure about the benignity or malignancy of the lesion.
Liver biopsy
Liver biopsies were performed to study liver diseases like hepatitis, cirrhosis or liver tumors.
The biopsy can be performed with a needle that reaches the liver from between 2 ribs on the right side or the front of the abdomen. For this the patient lies either side on the left side and arm raised, or face up. Is a local anesthetic and after opening the skin with a scalpel the needle for biopsy. The patient is asked to be as still as possible and also hold your breath while the needle. 3-5 punctures usually required. Sometimes the doctor will use an ultrasound to help.
Obtaining liver biopsy is a procedure with few complications and patient discomfort. The most common complication is bleeding internally, so in some cases the patient kept under observation.
Renal biopsy
Faced with some kidney diseases (especially glomerulonephritis) may be necessary to conduct a biopsy of the kidney. Usually this biopsy done percutaneously (through the skin) like ‘tru-cut’. With local anesthesia, makes a small incision in the lumbar region. Then, through the incision, the needle is inserted into the kidney, which is usually checked by ultrasound or Rx, and you get several samples. It is sometimes given some relaxing to minimize discomfort and facilitate patient cooperation.
Complications are rare (less than 1% usually) and rarely go beyond the bleeding well into the ducts of the kidney and urine (leading to blood in the urine and possible renal colic due to clots) or to the region back, causing a hematoma.
Bone marrow biopsy
Bone marrow is the organ responsible for producing blood cells. Their study, therefore, is crucial in the diagnosis of many blood diseases, such as certain anemias, leukemias, immunodeficiency and platelet disorders. It may also be needed bone marrow biopsy to diagnose infectious diseases or tumor that may be affected. Another reason to perform a bone marrow biopsy is the study prior to completion of a bone marrow transplant, both oneself and another person.
In the adult bone marrow is found mainly in the bones of the trunk, such as the sternum, and hip bones (iliac) which is where the biopsy. First the patient is given local anesthesia. Then insert a needle through the tough skin and bone to reach outside of the soft interior (bone marrow). At the end of the syringe needle is inserted and aspirated a sample of bone marrow is examined under a microscope.
credit to: Dr. Antonio Barrasa Shaw, Dr. Carl J. Brandt, Dr. John Pillinger, Dr. Philip Owen