BREAST BIOPSY

A surgical procedure in which, when the doctor suspects the presence of cancer, breast growth is removed and examined. The sample is either removed surgically or suctioned out through a needle.

Normal Anatomy of Breast

  • The breast is an exocrine gland.
  • Responsible for production and secretion of milk.
  • Consists of glandular and fatty tissue.
  • Proportions of components vary.
  • More fatty in older individuals.
  • In older patients, the breast itself lies between the second and sixth rib anteriorly and extends from the edge of the sternum to the mid-axillary line with underlying muscle; the breast tissue lies upon pectoralis major, and serratus anterior on its lateral aspect suspensory ligaments holds the breast to the pectoralis major.
  • Ligaments become stretched with increasing age.
  • Posterior to the nipple and areola the breast is composed of a complex tree-like structure called lactiferous duct, the purpose of which is to create and secrete milk.
  • Each breast consist of 15 to 20 lobes, lobe contains lobules; and each lobule has lactiferous duct.
  • Blood supply to the breast comes from a lateral thoracic artery which is a branch of the second part of the axillary artery; additionally, the breast is also served by the internal thoracic artery which we also refer to as the internal mammary artery.
  • Lymphatic drainage of the breast is extensive it involves anterior drainage by the pectoral nodes posterior drainage via the subscapular nodes lateral drainage is via the brachial and the internal thoracic, the breast is also drained by infraclavicular.

Changes in the breast

  • Lump
  • Thickening
  • Area feels different
  • Nipple discharge
  • Nipple indentation
  • Skin puckering, dimpling
  • Change in breast shape, pain

Evaluating a breast lump

  • Medical history
  • Physical exam
  • Diagnostic imaging
  • Biopsy

Biopsy types

  • Needle
  • Surgical

Needle Biopsy

  • It is equal to minimally invasive
  • Takes 10-60 mins
  • Removes small tissue sample
  • Done under local anaesthesia
  • Little scarring or pain

Surgical Biopsy

  • Accurate tissue sampling can be achieved
  • Small risks
  • Removes a large amount of tissue sample
  • Done under local anaesthesia