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Patient Education (6) Biopsy
OUTPATIENT HOSPITAL PROCEDURES
FOR A SURGICAL BIOPSY
If you are having a biopsy as an outpatient, you will be admitted to the hospital on the same day of your biopsy, and you will go home later that day. Before you go to the hospital, your doctor or nurse will tell you when and where to check in the hospital and inform you of the restrictions in regards to eating and drinking before your surgery. It is advised you leave your money and jewelry at home.
Before a biopsy, you will have a preop work-up. This consists of routine laboratory tests such as urine and blood tests, a chest X-ray, and an EKG (electrocardiogram, which electrically records the activity of the heart). In most cases the laboratory tests can be done several days before the surgery.
You may need to have a needle localization immediately prior to your biopsy, if you breast lesion is nonpalpable (cannot be felt). When a small abnormality is found by mammography and cannot be felt by the doctor, needle localization is utilized to locate the breast lesion preoperatively. This is a relatively simple and painless procedure performed in the hospital by a doctor who is a radiologist.
During the needle localization, the radiologist refers to your mammogram X-rays to locate the breast lesion. A local anesthetic is injected into the breast to numb it. All you will feel is a slight prick. Once the breast is numb, a needle is inserted into the breast at the approximate location of the lesion. At this point, additional mammogram X-rays are taken to see if the needle is close to the breast lesion. If the needle is positioned correctly, a thin wire is inserted through the needle into the area in question. When this wire is inserted correctly, the needle is removed from the breast leaving the wire at the site of the lesion. The wire is left in the breast and taped to the skin. You are then brought to the operating room for the breast biopsy, and the wire acts as a guide for the surgeon. Needle localization is a fairly painless procedure.
Once it is time for surgery, you will be given general anesthesia (you will be unconscious). It usually takes about 30 minutes to an hour to remove the suspicious tissue. During surgery, the surgeon follows the wire down to the hook and removes the tissue that has been localized. The tissue is then sent to the radiology department to make sure it corresponds to the mammographic findings, and then it is sent to pathology.
After surgery you will be taken to the recovery area for approximately one to two hours. Once your vital signs are stable, you will return to your room. Most patients have very little discomfort following a biopsy. After general anesthesia, you will probably be sleepy and want to rest.
Your surgeon will see you postop and inform you of his findings. In most cases he will have a diagnosis, but in some instances, the findings of the frozen section are not conclusive and it will be necessary to wait for the results of the permanent section. It may be a few days before your surgeon will know the final diagnosis.
Depending on how you feel, you will probably be ready to go home two to three hours after the biopsy. It is imperative a family member or friend drive you home. You are not allowed to drive after you have been under general anesthesia.
Before you leave the hospital, you will be given instructions for taking care of the incision. It is recommended you wear a bra 24 hours a day for at least two weeks after surgery. Patients report when wearing a bra it is more comfortable and there is less traction on the incision. If you have any questions, do not hesitate to ask your surgeon or discharge nurse. Call your surgeon if you have any excessive bleeding other than a small area on your dressing, you experience severe pain or swelling at the incision site, or you develop a fever of 101 degrees F or more.
You have been under stress and you may feel weak or tired; this is to be expected. Once home, you will be able to return to your usual activities within a day or two. Approximately a week after the biopsy, your surgeon will want to see you in his office to remove the stitches and discuss further treatment, if needed.
BREAST BIOPSY WITH AN ABBI (Advanced Breast Biopsy Instrumentation) Device
This type of breast biopsy is performed using an ABBI Devive. This device is a sophisticated device using a combination of mammographic computer imaging technique and a special cannula to remove a portion or all the malignant breast tissue under local anesthesia. This is best utilized for patients having a mammographic or nonpalpable breast lesion.
The procedure is usually done in a breast center or doctor's office. First, you the patient will be asked to lay on a so-called mammography table and the affected breast will be positioned in a special casing. The surgeon will then table a computerized picture of the breast and verify and precisely locate the position of the suspicious breast lesion. Once localized, local anesthesia will be injected in the skin of the breast and the breast will be squeezed in the right position. Using a special instrument or cannula, the lesion will then be tagged with a small T marker. The position is again verified. The cannula is then advanced and using it the surgeon will removed the suspicious breast mass or lesion. The surgeon will then verify he has removed the entire lesion. When done, the procedure is completed and the patient is discharged.
If your biopsy determines the lump or lesion is malignant, you will have to undergo a staging process. Staging refers to a series of diagnostic procedures that analyze the type and the extent of the malignant tumor. Your surgeon will schedule these procedures which may include special blood tests, additional X-rays, radioisotope scans, and/or computerized body scans.
Once these test are performed and the results known, the surgeon will determine the stage of the breast cancer. To see the different stage, click the following word (click the BACK button to return to this page).
A patient should have the opportunity to learn about recommended alternatives and to evaluate them. Before consenting to any course of treatment, ask your surgeon for information on:
Even if you want your surgeon to assume full responsibility for all decision making, you are likely to discover your anxiety over treatment decreases as your understanding of breast cancer and its treatment increases.
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