A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders. There are several types of breast biopsies, including stereotactic, ultrasound-guided and excisional breast biopsy. A biopsy may be done to evaluate abnormal findings on a mammogram, breast ultrasound or MRI, or a palpable mass that is thought to be benign. It can identify a number of breast conditions that are not cancer or precancer.
Your provider will discuss the meaning of your biopsy results with you, and will personalize treatment based on your results.
A duct excision is a similar procedure to an excisional breast biopsy, and is typically performed to remove an abnormal area in the breast duct system. The abnormal area may have been found on an ultrasound or ductogram after a woman noticed discharge from her nipple.
A lumpectomy is a procedure performed to remove a lump that may be breast cancer along with some of the tissue around the lump. Lumpectomy is often the preferred procedure for smaller breast lumps, and is often performed as an outpatient procedure. A pathologist will examine a sample of the removed breast tissue for testing to make sure all of the cancer has been taken out. In some cases, your surgeon may also remove lymph nodes in your armpit to see if cancer has spread to them.
The recovery period is typically very short for a simple lumpectomy. Many women have little pain, but if you do feel pain, you may take pain medicine, although it is important to discuss with your doctor. Most women can go back to their usual activities after a week or so. Avoid lifting, jogging, or any activities that cause pain in the surgical area for 1-2 weeks.
Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy is done to look for the spread of cancer into the lymph nodes in the underarm. On the morning of the surgery, a radioactive tracer is injected near the breast tumor, which is then is transported by your body to the sentinel (or first lymph node) in the axillary lymph nodes. It is then removed through a small incision at the base of the underarm.
Your surgeon may use a radiotracer and/or blue dye during the surgery to help locate the sentinel lymph node.
A mastectomy involves the removal of all breast tissue and sometimes the overlying skin and nipple. Most often, this procedure is done to treat breast cancer, although it is sometimes done to prevent cancer (prophylactic mastectomy). A plastic surgeon may be able to begin reconstruction of the breast during the same operation, or you may choose to have breast reconstruction at a later time. If you have reconstruction, a skin or nipple sparing mastectomy may be an option.
It is important to talk with your provider to choose the best option for you. The size and location of the tumor, skin involvement, number of tumors, and how much of the breast is affected are factors to consider. Your medical history, age, family history and general health will also be considered.
Most women will stay in the hospital for 24-48 hours after your surgery, although your length of stay will depend on the type of surgery.
If you and your healthcare provider have decided that mastectomy is the best treatment for you, please click on the link below for a list of questions that you may want to discuss with your provider about mastectomy and breast reconstruction.
Axillary Lymph Node Dissection
Axillary lymph node dissection is a procedure in which all of the lymph nodes in the axilla (underarm) are removed. This procedure is usually performed for patients with breast cancer that has spread to several lymph nodes, or for circumstances described to you by your surgeon. Sometimes, the dissection can be made through the mastectomy incision, or it can be made made through a separate incision made in the armpit (especially if done at a different time). After the lymph nodes are removed, a drain will be left under the skin to prevent fluid from building up under the incision. Physical therapy is important for recovery after surgery, and will be discussed with you by your surgeon.