Breast lumps other diagnostic studies
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The only certain method to approve the presence of breast malignancy is breast lump biopsy.The three types of biopsies are core-needle biopsy, open surgical biopsy, and fine needle biopsy. Core-needle biopsy has different types such as ultrasound guided-core needle biopsy, stereotactic-guided core-needle biopsy, MRI-guided core-needle biopsy, and freehand core-needle biopsy. Core-needle biopsy has high sensitivity and specificity. Triple test score is used by surgeons for assessment of palpable breast lumps. Classic type of triple test includes clinical breast examination, FNA, and mammography and modified version includes clinical breast examination, core-needle biopsy and ultrasound.
Other Diagnostic Studies
There are three types of biopsy:
- Core-needle biopsy
- Open surgical biopsy
- Fine needle biopsy
- Ultrasound guided-core needle biopsy:
- Stereotactic-guided core-needle biopsy
- MRI-guided core-needle biopsy
- The needle is guided by Magnetic resonance imaging.
- Freehand core-needle biopsy
- Usually used for breast lumps which can be felt by hand on breast tissue.
Open surgical biopsy:
- Perform under general anesthesia
- If core-needle biopsy is unavailable due to location of breast lump, open surgical biopsy is required
- In patients with high risk of cancer is recommended
- 1-2 inch cut on breast tissue for breast lump removal
- Higher risk of complications (bruising, bleeding, pain and infection)
- Performed by small needle (21-25 gauge)
- Regarding to small amount of breast tissue, FNA is considered as controversial method for breast lump diagnosis
- Performed for large and symptomatic breast cysts or imaginary abnormalities
- Complications of FNA include bruising, bleeding, pain, infection and pneumothorax; if needle goes deep inside the chest)
- Due to inadequate tissue or nondiagnostic results, FNA has lower rate of diagnosis rather than core-needle biopsy
- FNA advantages:
- FNA follow-up:
- Classic triple test:
- Modified version of triple test
- Clinical breast examination, Core-needle biopsy and ultrasound
- Palpation, mammography and biopsy are required for women aged > 35 years
- Palpation, ultrasound and biopsy are suggested for women <35 years
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- Morris KT, Pommier RF, Morris A, et al. Usefulness of the Triple Test Score for Palpable Breast Masses. Arch Surg. 2001;136(9):1008–1013. doi:10.1001/archsurg.136.9.1008
- Wai CJ, Al-Mubarak G, Homer MJ, Goldkamp A, Samenfeld-Specht M, Lee Y; et al. (2013). "A modified triple test for palpable breast masses: the value of ultrasound and core needle biopsy". Ann Surg Oncol. 20 (3): 850–5. doi:10.1245/s10434-012-2710-y. PMID 23104707.
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