Minimally Invasive Breast Biopsy

A minimally invasive breast biopsy technique (MIBT) is a procedure in which your physician obtains a breast tissue sample using one of the following:

Fine needles to obtain cells.
Hollow core needles to obtain samples of tissue.
Specialized biopsy devices that use vacuum and cutting devices to remove tissue samples.

Following the procedure, the samples can be examined by a pathologist for cancer.

This type of technique is accurate and that accuracy is improved by your physician’s use of the following:

Ultrasound or mammogram assistance to make sure that the center of the lesion is sampled, even with lesions that can be felt (palpable lesions).
Devices that provide generous core samples as opposed to cells.
Tracking logs to record data, verifying quality performance of procedures, as well as assuring that the imaging and biopsy results match.

The use of a minimally invasive biopsy technique has the following advantages:

It allows distinction of breast cancer from benign (noncancerous) lesions with high degree of accuracy and minimal scarring.
It allows diagnosis of breast cancer without taking a patient to surgery.
It preserves normal breast tissue.
It allows for better cosmetic results.
It decreases the number of operations required for cancer treatment.
It keeps all options of breast cancer treatment open for patients, including the inclusion into clinical trials of new medicines and therapies.
It preserves the options of cancer staging, imaging, consultations with plastic surgeons, and the use of genetic testing prior to breast cancer surgery.

Richard E. Fine, MD, FACS

Director of Education and Research, The Margaret West Comprehensive Breast Center, Germantown, TN

Associate Professor Department of Surgery, University of Tennessee Health Science Center, College of Medicine

Some lesions cannot be sampled by MIBT, including those in the following types of circumstances:

The lesion is close to skin, chest wall, implant, or devices.
The lesion is not well visualized by mammogram, ultrasound, or breast MRI.
The patient cannot tolerate the procedure due to physical or mental challenges, such as severe COPD or PTSD.
The patient declines an MIBT after informed consent is discussed.
The results of an MIBT in some cases, such as the following, may be inconclusive and require an open surgical biopsy to get a diagnosis:

-Atypia

-Papillary lesions

-Radial scars
Unexpected, or discordant, results, based on what has been seen on a mammogram, ultrasound, or MRI (that is, the imaging and biopsy results don’t match)

The following organizations have approved the use of MIBT:

The American Society of Breast Surgeons (Society Consensus Statement)
American College of Radiology
National Comprehensive Cancer Network
European Society of Breast Cancer Specialists
American College of Surgeons through the NAPBC (National Accreditation Program for Breast Centers)