Preparation
The preparation of the biopsy of the breast initially consists of a detailed indication by anamnesis, physical examination and imaging (ultrasound, MRI of the breast). Afterwards, the exact procedure for taking the sample can be chosen, mainly based on the imaging. Depending on the type of suspected tissue alterations, open or closed biosynthetic samples can be taken.
Computer simulations and models can also be used to determine which access route is best suited for biopsy. Affected persons must also be informed in good time before the procedure and must of course agree to the examination. Further preparations mainly concern the type and manner of the (usually local) anaesthesia used.
Procedure
The procedure for breast biopsy is usually slightly different, depending on which procedure is chosen. In most cases the sample collection is performed under image control. This can be done either by ultrasound or MRI.
The site where the biopsy needle is to penetrate the skin must first be disinfected. If several biopsies are planned, local anaesthesia of the skin and the underlying layers is often performed. In the case of a single biopsy, the puncture with the anaesthetic syringe would be just as unpleasant as the puncture through the puncture needle, so that in consultation with the person examined, anaesthesia is usually dispensed with.
Depending on the type of procedure, a vacuum biopsy, a punch biopsy or an aspiration biopsy is then performed. All procedures are based on a needle which is inserted into the suspicious tissue. A sample is then introduced into the cavity of the needle by various mechanisms.
The tissue sample is then microscopically examined as quickly as possible. If necessary, the sample must first be preserved in a tube and sent to a pathology institute. The puncture site itself can usually be closed again with a simple patch. Only open biopsies require a slightly different procedure, in which the skin and underlying layers must be surgically removed and, accordingly, properly sutured again after the biopsy has been taken.
How painful is that?
Most biopsies of the breast are performed using biopsy needles. If only a single sample is taken, it is a single needle stick. As this is no less unpleasant than an anaesthetic injection, local anaesthesia is usually not required.
If several biopsies are taken, a local anaesthetic of the skin and the underlying layers can be performed beforehand. You can feel the sting of the anaesthetic needle and the anaesthetic can also cause some pressure in the tissue. However, the biopsy itself is not noticed afterwards. These needle biopsies can cause pain when the anaesthetic wears off. However, the pain usually disappears after a few hours or days.
Do you need an anesthetic for that?
Whether an anaesthetic is used for the biopsy of the breast depends very much on the procedure used. Open biopsies are a surgical procedure, which is often performed under general anaesthesia. Biopsies that are performed with needles are either performed under local anaesthetic or, in consultation with the person concerned, without anaesthetic (if only one or two stitches are required).
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