JSASA For Advanced Breast Surgery & Treatment
One of our primary focuses at JSASA is the treatment of breast disease, breast biopsy and breast cancer. We perform a number of procedures including:
- Routine & high-risk screening for breast cancer
- Needle aspiration breast biopsy
- Sentinel lymph node breast biopsy
- Breast-sparing procedures
- Mastectomy (complete breast removal)
- Lumpectomy (breast lump removal)
- Fibrocystic surgery
- Complex cyst surgery
- Benign lesion surgery
- Breast infection surgery
Breast Biopsy Techniques
When we detect an abnormality in the breast, either by examination or mammogram, we often recommend a breast biopsy. Your surgeon will choose the biopsy approach that is most appropriate for you based upon the nature and location of the abnormality. Some abnormalities require a surgical approach for complete evaluation, while others may be evaluated with a needle biopsy.
Stereotactic (Mammotome) Breast Biopsy
A needle biopsy (either a fine needle aspiration biopsy or a core needle biopsy) involves placing a needle into the abnormal area to remove a small amount of tissue for analysis. If there is a lump that can be felt, your surgeon may be able to do this type of biopsy in the office. If the abnormality is not palpable, or if it is deep in the breast, we can perform a needle biopsy using either ultrasound guidance or a stereotactic biopsy. The ultrasound or stereotactic mammogram images allow for precise placement of the needle. We do needle biopsies that require local anesthesia, take very little time and usually cause only mild discomfort.
When an abnormality can only be seen by mammogram, we may do a stereotactic core biopsy. This is sometimes called a Mammotome biopsy. Mammotome is the brand name for the equipment. We perform this biopsy with a special, automated needle with sophisticated computer guidance based on mammogram images.
What To Expect During A Stereotactic Biopsy
During the examination, the lights in the room will be dimmed and you will be asked to lie on your stomach on a specially designed table. There is an opening in the table for your breast. We perform this procedure using a mammography unit mounted underneath the table. We first obtain several localizing mammograms to confirm the area to be biopsied. We administer local anesthesia and perform the biopsy. With each sampling you will hear a click and feel a bit of pressure. Most women do not feel any significant pain. This procedure typically takes about one hour.
You can expect some discomfort, bruising and swelling after a needle biopsy. Most patients experience mild symptoms. Applying ice to the breast (on and off, no more than 30 minutes at a time) can help reduce bruising and swelling. You may use Tylenol (2 tablets every 4 hours) or Ibuprofen (1 tablet every 4 hours) for the discomfort. Most women also find that a supportive sports-type bra makes them more comfortable for the first 24 hours (overnight). It is usually not necessary to restrict your activities after a needle breast biopsy. As long as you feel well, you may resume your normal schedule. Bruising typically resolves in 5 to 7 days.
Surgical Breast Biopsy
When a breast lesion needs removal or a needle biopsy cannot provide enough tissue for analysis, we perform a surgical breast biopsy in an operating room. The surgeon removes the abnormal tissue in order to accurately diagnose the abnormality. Surgical breast biopsy is an outpatient procedure. Your surgeon will decide which type of anesthesia is most appropriate for keeping you comfortable during the procedure. We may use local anesthesia, local anesthesia combined with intravenous sedation, or general anesthesia. If you have intravenous sedation or general anesthesia, you will spend some time in the recovery room before you can go home. Risks and complications of a surgical breast biopsy include infection, bleeding, bruising, hematoma (a blood clot near the surgery) and seroma (a fluid collection near the surgery). There may also be a change in the appearance of the breast as a result of the procedure.
Needle Localization (Wire Localization)
If we cannot feel the abnormality on examination, we will do a surgical biopsy with needle localization. We perform needle localization, sometimes called wire localization, in the radiology department just before your scheduled surgery. The radiologist identifies the abnormal tissue using mammograms, ultrasound or MRI (whichever technique shows it best). Using local anesthesia, the radiologist inserts a small needle into the area of concern. We confirm the location then pass a thin, flexible wire through the needle. We remove the needle and tape the wire to your breast. We take one final set of mammograms to ensure that the wire is located in the correct area. You are then sent to the operating room, where your surgeon uses the wire and X-rays to locate and remove the abnormality.
Mastectomy or Lumpectomy?
Many factors will determine which procedure is best for you. Your surgeon will explain your treatment options and risks before performing a mastectomy or lumpectomy and discuss your condition and your personal preferences.
Discover exceptional breast surgery and treatment at JSASA. Call 732-775-5005 or use our convenient Request an Appointment form.