Biopsy radiology and senology

A biopsy is a procedure, during which we take a sample of tissue or cells, which is examined at a specialized, histological laboratory afterwards. Biopsies are particularly important for breast cancer diagnostics. If changed focal lesions or calcification are found during mammography, a biopsy must be carried out in order to analyze the tissue. In most cases, the examined tissue is not cancerous and further treatment is not necessary. Due to this fact, it is essential to carry out biopsies as carefully and minimally invasively as possible.

When is a biopsy indicated?

When is which kind of biopsy performed?

There are different kinds of biopsy. The kind of surgery to be performed depends on the medical questions and the localization of the suspicious tissue. In general, the method most gentle is used to receive best diagnostic results.

If non-invasive medical imaging examinations showed an abnormality of breast tissue, taking a sample of this tissue and histologically analyzing it is inevitable in order to estimate whether it is benign or malignant.

How are different kinds of biopsy carried out?

Vacuum-assisted biopsy

One of our biopsy procedures is the vacuum-assisted biopsy. During this kind of biopsy, a hollow needle is inserted into the breast. By creating a vacuum, the tissue is sucked into a lateral opening of the needle and removed. Turning the needle makes it possible to take several cylindrical samples from a suspicious area without a new puncture. In order to place the needle exactly and to avoid new punctures, a medical imaging procedure (mammography, ultrasound or MRI) is carried out. The complex interaction between medical imaging, guiding the needle and extracting tissue is especially reliable in case of micro-calcifications.

Ultrasound-assisted punch biopsy

During ultrasound-assisted punch biopsy, a punch needle is “shot” into the tissue, whose top is so sharp that we can extract cylindrical tissue samples, guided by ultrasound. It is generally necessary to insert the needle several times to get clear diagnostic results. Thus, local anesthetics are applied.

Biopsy and tomosynthesis

Digital breast tomosynthesis is an advanced type of digital mammography, creating three-dimensional layers of the breast. This is not only a diagnostic advantage but also beneficial while performing a biopsy. Especially very dense breast tissue can be evaluated better during a digital breast tomosynthesis, and this adds to the safety of women with dense tissue when carrying out a vacuum-assisted biopsy. Another advantage: we can take samples of lesions that are not visible in ultrasound or digital mammography images.

Psychological stress caused by biopsy

Psychological stress is often more severe than the physical stress patients experience. Although most results of biopsies are good, the uncertainty until receiving those results is a heavy burden. Because of this, we try not only to use state-of-the-art biopsy procedures most gentle, but we are also trying to get the results and, thus, certainty, as fast as possible. It is also essential to clarify pathological/bad results. Breast cancer is always very individual as well as the corresponding treatment options. But it is important to keep in mind that breast cancer–if detected at an early stage–has good chances to be cured in comparison to other types of cancer. Therefore, receiving examination results quickly is indispensable.