The breast biopsy

The biopsy is performed when a lesion is suspected or detected either on sonography or mammography and it is necessary to find out whether the lesion is benign or malignant or else there might be an inflammatory process. After the microscopic examination of the sample the pathologist can tell what kind of lesion it is. If it is a cancer, then a further immunohistochemical examination is needed to distinguish the subtype of the tumor. During that examination the amount of hormonal receptors or Her2neu status and Ki67 cell division activity in tumor cells are evaluated. Molecular subtype is needed for further neoadjuvant, hormonal or targeted chemotherapies, sometimes also the combination of all three. Sometimes Her2neu status is evaluated as equivocal. In those cases another examination which is called FISH testing is needed, which evaluates if mutation is present in the Her2neu gene. Positive Her2neu status allows the clinician to perform neoadjuvant hormonal chemotherapy with a drug called Herceptin.

It is important to mention that after biopsy benign lesions do not become malignant and malignant ones cannot become more aggressive and the biopsy is necessary and irreplaceable if there are medical indications. After the procedure hematomas, bleeding or pain can follow. Patients often wonder if the process is painful. The ones who have gone through the procedure say that what they felt was more of discomfort rather than pain, although it is a subjective sensation and can be varied. Moreover, it is essential to mention that due to modern medicine achievements, breast cancer can be treated in most cases if detected in time. For a probable early detection monthly self-observation is needed, however, one should consider that not all the lesions can be palpated, besides, preventive measures should be taken: sonography (if the patient is 30-40 years old) or mammography (if the patient is 40 years old or above).