Obtaining an accurate diagnosis requires both sampling of the correct area of the breast and expert examination of the obtained tissue. UC Irvine clinicans have extraordinary resources at their disposal to accomplish the goal of obtaining an accurate diagnosis.
Localizing Areas of Concern
At UC Irvine we routinely use one of three methods (Ultrasound, MRI, PET/CT) to make sure that the biopsies we obtain are from the correct part of the breast. The fact that the entire range of technologies to localize regions of the breast for biopsy are located at one institution provides important benefits for our patients and is unmatched by any other single Southern California location.
Most often ultrasound localization of breast lesions allows the biopsy of areas of concern. However, sometimes areas of concern cannot be unambiguously identified by ultrasound. In these cases, UC Irvine physicians employ alternate imaging technologies to direct biopsies.
Fine Needle Aspiration
Fine needle aspirate biopsies obtain single cells or small groups (clumps) of cells. Although this type of biopsy is very well tolerated by breast patients, the limited amount of material available for evaluation by the pathologists poses technical challenges especially in light of new "targeted" therapies. This biopsy technique is on the opposite end of the spectrum from having a piece of the tumor removed by surgery and we believe use of this technique is more tolerable for breast patients and in the hands of experts provides excellent diagnostic accuracy. New techniques for analyzing FNA biopsies are being developed at UC Irvine in order to provide important new information that may help predict which women would respond to specific therapies, such as anti-angiogenic therapy (somehow link to Immunotherapy & Nanotechnology).
Core Needle Biopsy
Core needle biopsy techniques involve insertion of a larger needle the retrieves a piece of breast tissue. This piece of tissue is typically about 1cm (1/4 0f an inch) long and 1 mm (1/16 of an inch) in diameter. This is slightly smaller than the lead of a standard pencil. This provides our pathologists more tissue to look at and divide up for the various evaluations noted above. As expected this technique is a little more uncomfortable than the FNA biopsy, but breast patients still report that it is much more tolerable than a surgical removal of a piece of breast tissue. Currently, this biopsy technique is most widely used in the breast health community for breast lesions that we have a high level of suspicion for being cancer.