Which cases need to biopsy the breast under ultrasound guidance, X-ray?

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Le Hong Lien - Department of Obstetrics and Gynecology - Vinmec Central Park International General Hospital.
A biopsy of the breast is to remove some cells and see if the neoplasm is benign or malignant. An ultrasound-guided breast biopsy is performed when the abnormal area in the breast is so small that it is not obvious to palpation.

1. Meaning of breast biopsy

Tumors or other abnormalities of the breast are often discovered by physical examination, ultrasound, mammogram, and other imaging studies. However, these investigations are not always able to tell whether neoplasms are benign or malignant.
Perform a breast biopsy to remove some cells – either surgically or through a less invasive procedure with a fine needle – from a suspicious area in the breast and examine them under a microscope to arrive at the diagnosis.

2. In which cases is a breast biopsy guided by ultrasound and X-ray performed?

In fact, there are many cases where the tumor is too small, not palpable, making it difficult for the procedure to remove cells for biopsy. Many statistics show that, about 50% of breast cancers that are not palpable because they are too small have been detected on radiographs based on the appearance of microcalcified nodules. In addition, about 80-90% of DCIS intraductal cancers present only as microcalcified nodules without any accompanying mass lesions.
At this time, breast biopsy under the guidance of ultrasound, X-ray is a better choice, can help doctors and technicians see the route of the biopsy needle, ensuring that cells are removed. most accurately suspect.
Under the guidance of ultrasound, three procedures can be performed:
Fine-needle aspiration, using a very fine needle to aspirate cells in the abnormal area Core biopsy uses a large-aperture needle to remove a tissue samples after each puncture. Localized with a hook wire, placing a needle in the suspicious area helps the surgeon locate the lesion during biopsy surgery. X-ray breast biopsy is usually indicated for cases of mammary gland lesions with suspected malignancy (BIRADS 4) or high suspicion of malignancy (BIRADS 5) that are only visible or clearly visible on mammography. Specific indications include:
Suspicious microcalcified lesions. Massive lesions, asymmetrical lesions, or areas of structural disturbance not identified on sonography. If there are many suspected malignancies, biopsies of all suspected lesions are necessary to fully evaluate the lesions and serve the treatment.

3. Advantages of breast biopsy under the guidance of ultrasound, X-ray

Ultrasound-guided breast biopsies Compared with surgical biopsies, this procedure is gentler, bleeds less, leaves no scars, and takes less than 1 hour Helps to obtain tissue samples efficiently reliable for determining the benign or malignant nature of breast tumors. Ultrasound does not use ionizing radiation. Ultrasound helps to visualize the route the needle goes to the breast lesion. Biopsy is the lesion located deep, close to the chest wall, but biopsies under three-dimensional position X-ray are difficult to perform. Ultrasound-guided biopsies are cheaper and faster than three-dimensional localized radiographs. The recovery time is short, and the patient can soon return to normal activities. This procedure takes no more than 1 hour. The patient is fully awake during the biopsy and may feel some discomfort or mild pain. Does not leave scars on the breast. X-ray-guided breast biopsies X-ray-guided biopsies of mammary gland lesions can use core biopsy techniques or vacuum-assisted biopsies. However, vacuum-assisted biopsy is still considered the standard of choice because of its ability to capture more lesions, including nodules-microcalcifications.
In particular, for patients with breast lesions classified from BIRADS 3 to BIRADS 5, the sub-radiographic biopsy with the vacuum assisted suction system has extremely high sensitivity and specificity, with an error of most as insignificant.

4. Some notes when biopsiing the breast under the guidance of ultrasound, X-ray.

The patient will have to undress and sometimes remove some jewelry that can interfere with the biopsy area. Patients need to inform the doctor about their current health status as well as the drugs they are using, the allergic state if any, especially to anesthetics. If anticoagulants are used, they should be discontinued within 3 days prior to biopsy. After the biopsy, if there is pain, the patient can use ordinary pain relievers. Occasionally, patients may experience swelling and bruising due to bleeding under the skin at the biopsy site. However, this condition will quickly go away, the patient should not be too worried. The patient must only notify the doctor if the biopsy area is enlarged, bleeding, red, or hot discharge persists in the biopsy breast. A relative or friend should accompany and take the patient home after the procedure. Vinmec International General Hospital now has a Breast Cancer Screening Package, which helps detect breast cancer early even when there are no symptoms.
When registering for the Breast Cancer Screening Package, customers will be examined and consulted directly with a highly qualified and experienced oncologist; Breast cancer screening by breast ultrasound on both sides, mammography (mammography), BRCA1/2 gene mutation test (if needed).
Especially, Vinmec International General Hospital is equipped with the most advanced breast cancer screening equipment in the world - Invenia TM ABUS. The outstanding advantage of Invenia TM ABUS is to maximize visibility, help tissues and tumors become clearer, and improve the level of accurate detection of lesions and abnormalities in women with dense glandular breast tissue. up to 90%.

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