Examination of the tissue sample | Importance of biopsy for breast cancer diagnostics

Examination of the tissue sample

The sensitivity and quantity of hormone receptors on the cancer cells, i.e. the quantity of receptors for the female sex hormones estrogen and progesterone, is determined by biochemical examination of the tissue sample. Since tumour cells are characterised by a disturbance of the normal functions of a cell, the ability to produce receptors for the sex hormones can also be lost. A distinction is made between oestrogen-receptor-positive and negative breast cancer cells (breast cancers).

This differentiation plays a role above all in the treatment options. If many receptors are present, this is a sign that the cancer responds well to hormone therapy. A further examination of the tissue sample will determine whether the tumour cells contain many HER2/neu receptors. These receptors allow growth factors to “dock” to the breast cancer cell, causing it to divide and thus stimulate the tumour to grow faster. This docking can be prevented with antibody therapy.

What are the risks of a biopsy?

With any biopsy there is a low risk of infection and/or bleeding. Bacteria can enter the breast tissue through the puncture channel and cause inflammation, but this is extremely rare. The puncture in the breast can injure blood vessels, which can lead to minor bleeding. There is only a risk here if the patient has a blood clotting disorder or is taking anticoagulant medication (e.g. aspirin). In order to clarify this in advance, blood is taken before each biopsy, the coagulation of the blood is examined and a list of the medication taken is drawn up.

How long does the sample collection take?

How long the removal of a tissue sample takes in individual cases depends on both the type of biopsy and the doctor taking the sample. In most cases it is carried out in an outpatient setting, which means that patients can usually go home after the sample has been taken. Normally the collection takes a few minutes and is controlled by means of imaging techniques.

The puncture of the needle is little or not noticeable, as the skin and the tissue in the puncture area are temporarily rendered insensitive to pain with a local anaesthetic. After removal, a pressure dressing is applied over the area of the tissue sample. In order to avoid acute complications, patients should remain in medical care for a few hours to avoid secondary bleeding, but can return home the same day.

What is to be observed after the collection?

The biopsy to classify a benign or malignant finding in the breast is a frequently performed procedure, which only rarely leads to complications. A slight bleeding and thus the formation of a bruise in the area of the tissue sample is normal and disappears after a few days. Depending on the method of taking the sample, a small scar may form.

A complication of this can be the formation of a scar proliferation, which usually only becomes a cosmetic problem. However, if the breast continues to bleed heavily and persistently in the days following the procedure, this may be an unintended consequence of the biopsy and should be presented to your doctor immediately. In order to avoid this consequence, it is generally recommended to wear a tight pressure bandage and bra and to take care of yourself physically after the biopsy.

In rare cases, the procedure may also allow bacteria to enter the punctured area, potentially causing inflammation. It is therefore important not to go to swimming pools or saunas in the hours or days after sampling. If the puncture site reddens, swells, overheats or becomes more pressure sensitive, your doctor should be consulted to rule out an inflammation or, if necessary, treat it in time.