What you need to know about:

Core Needle Breast Biopsy (CNB)

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Overview of

Core Needle Breast Biopsy (CNB)

in Thailand

A Core Needle Breast Biopsy (CNB) is a medical test which can identify the cause of an abnormal lump or calcification in the breast. A radiologist performs this procedure in the radiology department. During the procedure, the radiologist inserts a needle into the abnormal area under the imaging guidance (ultrasound or X-ray) and removes a sample of the tissue, which is given to a pathologist, who looks at it under a microscope. The pathologist can determine what the abnormal tissue is: cancer, non-cancerous tumor, infection, or scar

Goals of

Core Needle Breast Biopsy (CNB)

A core needle breast biopsy can provide your doctor with a sample of tissue that will allow him/her to identify and diagnose abnormalities in the cells that make up breast lumps, other unusual breast changes, or suspicious or concerning findings on a mammogram or ultrasound. The lab report from the breast biopsy can help determine whether you need additional surgery or other treatment.  

Your doctor may recommend a core needle breast biopsy if:  

-You or your doctor feels a lump or thickening in your breast, and your doctor suspects breast cancer

-Your mammogram shows a suspicious area in your breast

-An ultrasound scan reveals a suspicious finding

-Your breast MRI reveals a suspicious finding

-You have unusual nipple or areolar changes, including crusting, scaling, dimpling skin or a bloody discharge

Price of

Core Needle Breast Biopsy (CNB)

Average Cost

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Pros and cons of

Core Needle Breast Biopsy (CNB)

Pros

-Core needle biopsies usually allows for a more accurate assessment of a breast mass than fine needle aspiration (if the sample is found to be solid or cloudy, suspicious-looking fluid) because the larger core needle usually removes enough tissue for the pathologist to evaluate abnormal cells in relation to the surrounding small sample of breast tissue taken in the specimen.  

-The procedure is less invasive than surgical biopsy, leaves little or no scarring and can be performed in less than an hour.  

-Ultrasound guided core needle biopsy uses no ionizing radiation and reliably provides tissue samples that can show whether a breast lump is benign or malignant. Ultrasound allows the doctor to follow the motion of the guided needle as it makes its way into breast tissue, minimizing the chances of complications  

-Ultrasound guided core needle biopsies cost less than other procedures such as open surgical biopsy or stereostatic biopsy.

Cons

-A core needle biopsy, like a fine needle aspiration, only removes samples of a mass and not the entire area of concern. Therefore, it is possible that a more serious diagnosis may be missed by limiting the sampling of a suspected lesion.

How it works:

Core Needle Breast Biopsy (CNB)

A core needle biopsy may be used to assess a breast lump that's visible on a mammogram or ultrasound or that your doctor feels (palpates) during a clinical breast exam. A radiologist or surgeon uses a thin, hollow needle to remove tissue samples from the breast mass, most often using ultrasound guidance. Several samples, each about the size of a grain of rice, are collected and analyzed to identify features indicating the presence of disease. Depending on the location of the mass, other imaging techniques, such as a mammogram or MRI, may be used to guide the positioning of the needle to obtain the tissue sample.

Preparation before

Core Needle Breast Biopsy (CNB)

Pre - treatment

Before the breast biopsy, tell your doctor if you:  

Have any allergies Have taken aspirin in the last seven days

Are taking blood-thinning medications (anticoagulants) Are unable to lie on your stomach for an extended period of time

If your biopsy will be done using magnetic resonance imaging (MRI), tell your doctor if you have a cardiac pacemaker or other electronic device implanted in your body or if you're pregnant or think you may be pregnant. An MRI generally isn't recommended under these circumstances.  

Wear a bra to your appointment.

Your health care team may place a cold pack against the biopsy site after the procedure, and the bra can hold the cold pack in place and provide support for your breast.

Recovery after

Core Needle Breast Biopsy (CNB)

Post - treatment

With all types of breast biopsy except a surgical biopsy, you'll go home with only bandages and an ice pack over the biopsy site. Although you should take it easy for the rest of the day, you'll be able to resume your normal activities within a day. Bruising is common after core needle biopsy procedures. To ease pain and discomfort after a breast biopsy, you may take a non-aspirin pain reliever containing acetaminophen (Tylenol, others) and apply a cold pack as needed to reduce swelling. If you have a surgical biopsy, you'll likely have stitches (sutures) to care for. You will go home the same day of your procedure and you can resume usual activities the next day. Your health care team will tell you how to protect your stitches.

Risks & side effects

During the biopsy, there is a less than one percent risk of internal or external bleeding or the tissue removed may not be enough for testing. Call your doctor if you notice any of the following: Increased bleeding at the biopsy site. While waiting to see the doctor, place pressure on the site and/or use a cold pack to temporarily stop bleeding. Chills for fever (temperature above 38 degrees Celsius or 100 degrees Fahrenheit) Pain, swelling, and/or redness at the biopsy site that is not managed by a cold compress or pain medication.

FAQs:

Core Needle Breast Biopsy (CNB)

What does a core needle breast biopsy show?

A pathologist will look at the biopsy tissue and/or fluid to find out if there are cancer cells in it. Results is likely to clearly show if cancer is present, but it can still miss some cancers. Be sure to ask your doctor when you can expect to get the results of your biopsy. If the results of the biopsy do not give a clear diagnosis, or your doctor still has concerns, you might need to have a second biopsy or a different type of biopsy to determine the pathological cause of your mass.

When can I expect to get my results?

It may be several days before the results of a core needle biopsy are available. After the biopsy procedure, your breast tissue is sent to a lab, where a doctor who specializes in analyzing blood and body tissue (pathologist) examines the sample using a microscope and special procedures.  The pathologist prepares a pathology report that is sent to your doctor, who will share the results with you. The pathology report includes details about the size and consistency of the tissue samples, the location of the biopsy site, and whether cancer, noncancerous (benign) changes or precancerous cells were present.  If your breast biopsy reveals normal results or benign breast changes, your doctor will need to see if the radiologist and pathologist agree on the findings. Sometimes the opinions of these two experts differ. For instance, your radiologist may find that your mammogram results suggest a more-suspicious lesion such as breast cancer or precancerous lesion, but your pathology report reveals normal breast tissue. In this case, you may need more surgery to obtain more tissue to further evaluate the area.  If your pathology report says that breast cancer is present, it will include information about the cancer itself, such as what type of breast cancer you have and additional information, such as whether the cancer is hormone receptor positive or negative. You and your doctor can then develop a treatment plan that best suits your needs.

What is the difference between an aspiration and a biopsy?

There are a few differences between the two. A core needle biopsy is done with a larger needle and a small incision is made in the skin above the area to be biopsied. The incision allows for easier insertion of the needle, but is not needed when performing an fine needle aspiration because the needle used is very thin.

Will the procedure hurt?

People interpret pain differently, but the core biopsy procedure is done with local anesthetic. Other than the sting from the anesthesia injection, you should not feel any pain. If you do experience significant pain, be sure to tell someone. After the procedure the area may be a little sore and bruised, but there are no other serious side effects. If you are nervous about the procedure speak to your health care provider and they should be able to accommodate you. In most cases a local anesthetic is used. This numbs the area to be biopsied preventing any feelings of pain and is administered with a very small needle, which usually only causes a slight sting. If you are nervous or anxious about the procedure, speak with your healthcare provider.

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