First When a concerning mass or lump is identified in the breast, a biopsy is needed to determine the cause of the mass. A biopsy is a procedure to sample or remove the concerning mass. A pathologist later evaluates the biopsy sample under a microscope to determine if any cancer or pre-cancerous cells are present. Most biopsies are performed with a core needle under local anesthesia (Needle Biopsy). Some are performed in the operating room through an incision under anesthesia (Open Surgical Biopsy). Nearly 80% of all breast biopsies are not cancerous.
Needle Biopsy or Open Surgical Biopsy?:
Most biopsies can be accurately performed by guiding a small sampling needle into the concerning area using local anesthesia. This is best performed with imaging (Ultrasound/Mammography/MRI) to make sure the correct area is biopsied. IMAGE GUIDED NEEDLE BREAST BIOPSIES ARE THE STANDARD OF CARE when it is possible to perform them. Only when an image guided breast biopsy is not feasible, do we recommend an Open Surgical Breast Biopsy.
“Vacuum assisted biopsy device commonly used for needle biopsies”
Needle biopsy = vacuum assisted needle biopsy = core needle
Most areas that are determined to be benign by needle breast biopsy will not need to be removed in surgery. Most can be followed with subsequent breast imaging studies and routine breast screening. Breast cancer surgery is best performed in the operating room when a cancer diagnosis has already been determined by a Needle Breast Biopsy.
Our Image Guided Biopsy Rate for Diagnosing Cancer:
(Ultrasound and Stereotactic Guided Needle Breast Biopsies)
Minimally Invasive biopsy = Standard of Care
We feel that this is the standard-of-care approach to a suspicious breast lesion, if it is a technically feasible procedure. Unfortunately, many surgeons do not fully embrace this approach to breast cancer. A recent 2009 study at Columbia Medical Center in New York showed that only 70% of breast cancers are diagnosed by needle biopsies. This likely represents many, if not most major medical centers. "Where's the Outrage!" was the title of a companion article by leading breast surgeon, Melvin Silverstein, MD. He was appalled by this suboptimal care across the country.
We are proud that our breast cancer patients are diagnosed by minimally invasive techniques. Our image biopsy rate of 95% exceeds all "Best Practice" recommendations.
NVBS is a division of Drs. Farr, Wampler, Henson, Williams, Dougherty, Brown, Ltd.