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Breast mass - Large Biopsy 3-6 cm

Biopsy
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Histopathology of large-sized breast mass.

₹666₹951

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Breast Mass - Large Biopsy 3-6 cm

  • Why is it done?
    • Tissue diagnosis of palpable or imaging-detected breast masses measuring 3-6 cm in size
    • Differentiate between benign and malignant breast lesions to establish definitive histological diagnosis
    • Evaluate masses that are suspicious for malignancy based on clinical examination or imaging findings (mammography, ultrasound, or MRI)
    • Obtain adequate tissue samples when smaller biopsy techniques are insufficient or contraindicated
    • Characterize complex cystic and solid masses or masses with uncertain imaging characteristics
    • Provide guidance for treatment planning in confirmed malignancies (tumor grading, hormone receptor status assessment)
    • Typically performed when needle core biopsy, fine needle aspiration, or excisional biopsy results are non-diagnostic or inconclusive
  • Normal Range
    • Normal (Benign) Result: Histological findings consistent with benign breast pathology (e.g., fibroadenoma, papilloma, fibrocystic changes, fat necrosis, phyllodes tumor benign variant)
    • Negative for Malignancy: No malignant cells identified in tissue sample; tissue shows normal breast architecture or recognized benign pathology
    • Adequate Tissue Sampling: Biopsy specimen contains sufficient diagnostic material representing the lesion in question with appropriate fixation and histological processing
    • Interpretation Units: Results reported as histopathological diagnosis using standardized nomenclature and WHO classification for breast lesions; graded on scale from benign to malignant
  • Interpretation
    • Benign Findings (Normal): Indicates no malignant process; patient generally requires routine surveillance and clinical follow-up per standard breast cancer screening guidelines; repeat biopsies typically not necessary unless imaging changes occur
    • Malignant Findings (Positive): Confirms presence of carcinoma (invasive ductal carcinoma, invasive lobular carcinoma, or other malignant histology); requires immediate referral to surgical oncology, medical oncology, and radiation oncology for treatment planning and staging; additional imaging and laboratory studies typically warranted
    • High-Risk/Atypia Findings (Atypical Hyperplasia): Includes findings such as atypical ductal hyperplasia or atypical lobular hyperplasia; significantly increased breast cancer risk; requires more aggressive surveillance, possible excisional biopsy for complete lesion removal, and consideration of chemoprevention therapy
    • In-Situ Carcinoma: Ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS); represents non-invasive malignancy with variable risk of progression; managed with excisional surgery, radiation therapy per oncologic guidelines, and close surveillance
    • Insufficient/Non-Diagnostic Sample: Inadequate tissue or failure to sample target lesion; requires repeat biopsy or alternative diagnostic modality to ensure reliable diagnosis
    • Factors Affecting Interpretation: Tissue sampling site accuracy, quantity of tissue obtained, proper fixation and processing, presence of crush artifact or necrosis, pathologist expertise in breast pathology, and correlation with imaging findings
    • Pathological Classification: Results often classified using Nottingham or Scarff-Bloom-Richardson (SBR) grading system for invasive carcinomas; hormone receptor status (ER/PR), HER2 status, and Ki-67 proliferation index documented when malignancy confirmed
  • Associated Organs
    • Primary Organ System: Breast tissue and associated lymphatic/vascular structures; integumentary system and underlying chest wall musculature
    • Common Malignant Conditions Diagnosed: Invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), triple-negative breast cancer, HER2-positive breast cancer, hormone receptor-positive breast cancer, inflammatory breast cancer, and phyllodes tumor malignant variants
    • Benign Conditions Identified: Fibroadenoma, papilloma, fibrocystic changes, lipoma, fat necrosis, adenosis, sclerosing adenosis, complex fibroadenoma, phyllodes tumor benign/borderline types
    • Potential Complications of Abnormal Results: Spread of malignancy to regional lymph nodes (axillary, internal mammary, supraclavicular), distant metastasis to lungs, bones, liver, and brain, involvement of skin and chest wall in advanced disease, systemic effects of cancer cachexia and paraneoplastic syndromes
    • Secondary Sites of Involvement: Lymph nodes, lung, bone, liver, brain, contralateral breast, pleura, and peritoneum; risk escalates with higher grade, stage, and hormone receptor/HER2 status
    • Biopsy-Related Complications: Hemorrhage and hematoma formation, infection/abscess, nerve injury with chronic neuropathic pain, vessel injury, pneumothorax if near chest wall, seromas, keloid formation, and rare necrotizing fasciitis
  • Follow-up Tests
    • If Malignancy Confirmed: Sentinel lymph node biopsy or axillary lymph node dissection, staging imaging (CT chest/abdomen/pelvis, bone scan or PET-CT), baseline laboratory studies (CBC, CMP, tumor markers), cardiopulmonary assessment prior to chemotherapy, genetic testing (BRCA1/BRCA2, other germline mutations if indicated)
    • Immunohistochemical Studies: Estrogen receptor (ER), progesterone receptor (PR), HER2 status, Ki-67 proliferation index for malignancies; these determine treatment options and prognosis
    • If Atypia or High-Risk Lesion: Excisional biopsy for complete lesion removal, discussion of chemoprevention (tamoxifen or aromatase inhibitors), enhanced surveillance with short-interval follow-up imaging
    • If Benign Findings: Routine mammographic surveillance (typically annual or per standard guidelines), clinical breast examination, reassurance and education regarding benign pathology, no additional imaging unless new symptoms develop
    • If Non-Diagnostic/Insufficient Sample: Repeat biopsy using alternative technique, surgical excisional biopsy, advanced imaging correlation (ultrasound-guided or stereotactic re-assessment)
    • Molecular Testing (if indicated): Gene expression profiling (Oncotype DX, MammaPrint), multigene panel testing for treatment selection and prognosis stratification in confirmed malignancies
    • Monitoring Frequency: Benign: Annual mammography; Atypical: 6-month interval imaging then semi-annual; Malignancy: Per oncologic treatment protocol; baseline imaging every 6-12 months during active treatment, then surveillance imaging per oncology follow-up guidelines (typically annually for 5+ years)
  • Fasting Required?
    • Fasting Required: No
    • Pre-Procedure Preparation: Patient may eat and drink normally; no dietary restrictions necessary
    • Medications to Avoid: Aspirin and NSAIDs (ibuprofen, naproxen) should be discontinued 5-7 days prior to procedure to reduce bleeding risk; anticoagulants (warfarin, dabigatran, apixaban, rivaroxaban) require consultation with prescribing physician and biopsy provider regarding timing and bridging therapy; continue other medications as directed
    • Specific Instructions: Arrange for local or general anesthesia depending on biopsy technique; have responsible adult present for transportation if sedation used; wear comfortable, easy-to-remove clothing; arrive 15-30 minutes early for check-in and consent verification
    • Pre-Procedure Imaging: Recent imaging studies (mammogram, ultrasound, or MRI within 1-2 weeks) required for procedural planning and lesion localization
    • Post-Procedure Care: Ice pack application for 15-20 minutes per hour for first 24 hours, support bra or compression garment for 1-2 weeks, acetaminophen for pain management, avoid strenuous activity and heavy lifting for 5-7 days, keep incision site clean and dry, monitor for signs of infection (fever, increasing redness, warmth, drainage), report complications to physician immediately

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