Editing Breast biopsy techniques (section)

== Core biopsy ==

* Preferred method for sampling breast lesions
** Allows examination of tissue architecture (differentiation between DCIS and carcinoma)
** Allows immunohistochemistry
* Perform under USS, stereotactic, or MRI guidance (use the easiest method available for that lesion)
** USS is best for mass lesions and generally easiest
** Stereotactic is best for calcifications and densities seen on mammogram, but is very uncomfortable (see below)
* Technique
** Infiltrate LA to skin, but no deeper
** Make a small nick with a number 11 blade
** Fix the lump between thumb and forefinger
** Penetrate the lump with core needle biopsy (8-14 gauge)
** Warn about clicking sound and fire
** Obtain at least 3 samples from each lesion, and transfer the samples to formalin bottles (if it's a good specimen, it will usually settle within the formalin)
** Clip should be placed and specimens should be imaged to confirm that the targeted lesion has been adequately sampled
* Failed biopsy is an indication for localisation and surgical excision