Methods of breast biopsy

A. Palpable masses. Fine-needle aspiration biopsy (FNAB) has a sensitivity ranging from 90-98%. Nondiagnostic aspirates require surgical biopsy.

1. The skin is prepped with alcohol and the lesion is immobilized with the nonoperating hand. A 10 mL syringe, with a 14 gauge needle, is introduced in to the central portion of the mass at a 90° angle. When the needle enters the mass, suction is applied by retracting the plunger, and the needle is advanced. The needle is directed into different areas of the mass while maintaining suction on the syringe.

2. Suction is slowly released before the needle is withdrawn from the mass. The contents of the needle are placed onto glass slides for pathologic examination.

3. Excisional biopsy is done when needle biopsies are negative but the mass is clinically suspected of malignancy.

B. Stereotactic core needle biopsy. Using a computer-driven stereotactic unit, the lesion is localized in three dimensions, and an automated biopsy needle obtains samples. The sensitivity and specificity of this technique are 95-100% and 9498%, respectively.

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