About Breast Biopsy

How is breast cancer diagnosed?
The process of diagnosing breast cancer includes three steps: an examination, imaging, and tissue sampling, where the final step is crucial.

In the initial breast examination, a doctor inspects both breasts and axillary lymph nodes for any lumps or abnormalities, a process known as a clinical examination.
The second step employs mammography or other imaging diagnostics such as ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI).
The third and crucial step for a correct diagnosis is a biopsy.

Are mammography and ultrasound sufficient for making a diagnosis?
No, the doctor cannot determine if a lesion is benign or cancerous only by performing a physical examination. Mammography and ultrasound are effective methods, but they alone do not provide a reliable answer. To confidently diagnose breast cancer, an analysis of cells or tissue from the suspicious area is needed. Therefore, all lesions must be analyzed using cell or tissue samples.

What is a breast biopsy?
A biopsy involves the removal of tissue or cells from a suspicious area in the breast.

Why are biopsies needed?
A breast biopsy is the only definitive diagnostic procedure that can determine if the suspicious area is cancerous. Apart from a reliable breast cancer diagnosis, biopsies also allow for:

• Determining the type of cancer.
• Determining the extent or size of a lesion.
• Optimizing an individualized treatment regimen.
• Monitoring the treatment and adjusting it, if necessary.

How is a breast biopsy performed?
Previously, biopsies were performed surgically with an incision. Nowadays, breast biopsies are usually performed by a radiologist using a less invasive procedure. This involves a hollow needle guided by imaging techniques (such as ultrasound) to ensure the sample is collected from the correct area.

How is a breast biopsy analyzed?
The tissue sample is sent to a pathologist, who analyzes it under a microscope to assess the tissue structure and cells. This microscopic analysis plays a central role in diagnosing cancer.

Who performs needle biopsies of suspicious lesions?
Image-guided, minimally invasive procedures such as ultrasound-guided breast biopsy are most often performed by a specially trained radiologist. This may vary across different countries.

Why is an axillary biopsy performed on breast cancer patients?
The axillary lymph nodes drain lymph from the tumor area. The spread of breast cancer usually first occurs to the lymph nodes in the armpit.

If one of the lymph nodes in the axilla appears suspicious on ultrasound, the doctor may collect a tissue or cell sample using a needle. An early examination of axillary lymph nodes provides accurate information regarding lymph node metastasis, prognosis, and treatment planning before any operation is performed. These samples are also taken by a radiologist or gynecologist and analyzed in the same way as breast tissue samples.