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Mass - Large Biopsy 3-6 cm

Biopsy
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No Fasting Required

Details

General tissue biopsy of unspecified mass.

₹666₹951

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Mass - Large Biopsy 3-6 cm

  • Why is it done?
    • Tissue diagnosis of suspicious masses between 3-6 cm in size to determine if lesions are benign or malignant
    • Evaluation of breast lesions that demonstrate uncertain or suspicious imaging characteristics on mammography or ultrasound
    • Assessment of palpable masses not clearly characterized by imaging modalities
    • Detection of malignancy in masses showing features suggestive of carcinoma or other significant pathology
    • Grading and classification of tumor cells when malignancy is identified
    • Performed when core needle biopsy is inadequate or when more tissue is required for comprehensive pathological examination
    • Typically ordered when imaging findings are BI-RADS 4 or 5 (suspicious or malignant)
  • Normal Range
    • Normal/Benign Result: Histopathology shows benign tissue characteristics with no evidence of malignancy, including fibroadenoma, lipoma, cyst, fibrocystic changes, or normal adipose tissue
    • Benign with Atypia: Lesions showing some atypical features but not meeting criteria for malignancy, such as atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH)
    • Interpretation Scale: Results are typically reported on a 6-category system: Category 1 - Benign (no malignancy) Category 2 - Benign with risk factors Category 3 - Uncertain/Probably benign Category 4 - Suspicious for malignancy Category 5 - Malignant Category 6 - Known malignancy
    • Units of Measurement: Descriptive histopathological diagnosis with histological grading (Bloom-Richardson or Nottingham grade 1-3 for invasive carcinomas)
    • Negative Result: No malignant cells identified; benign diagnosis provides reassurance and may conclude clinical workup
    • Positive Result: Malignant cells present indicating carcinoma; specific type and grade are documented for treatment planning
  • Interpretation
    • Benign Findings: Demonstrates normal breast tissue, fibroadenoma, lipoma, or other non-malignant lesions; typically requires routine follow-up imaging or clinical surveillance depending on subtype
    • High-Risk Lesions: Atypical hyperplasia or borderline lesions warrant close surveillance and may require additional intervention or excisional biopsy; associated with increased breast cancer risk
    • Ductal Carcinoma In Situ (DCIS): Non-invasive malignancy contained within ducts; requires surgical excision and close follow-up; graded as low, intermediate, or high grade
    • Invasive Carcinoma: Malignant cells penetrating ductal/lobular structures; type (invasive ductal, lobular, etc.) and histological grade (1-3) critical for prognosis and treatment; may include lymph node involvement assessment
    • Grade 1 (Well-differentiated): Slowest growing, most favorable prognosis
    • Grade 2 (Moderately-differentiated): Intermediate growth rate and prognosis
    • Grade 3 (Poorly-differentiated): Fastest growing, least favorable prognosis; requires aggressive treatment
    • Factors Affecting Results: Specimen size and quality, adequate sampling of lesion, pathologist expertise, immunohistochemistry findings (ER/PR/HER2 status), specimen fixation, and hormone receptor status
    • Clinical Significance: Results directly determine treatment approach (surgery type, chemotherapy eligibility, radiation therapy, endocrine therapy); guide prognosis and surveillance recommendations
  • Associated Organs
    • Primary Organ System: Breast tissue (mammary gland), part of integumentary system; may involve regional lymph nodes (sentinel lymph nodes, axillary nodes)
    • Breast Cancer Diagnosis: Definitive diagnosis of invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and other malignant subtypes
    • Common Associated Conditions: Fibroadenoma, phyllodes tumors, papilloma, lipoma, breast cyst, fibrocystic breast disease, atypical hyperplasia, lymphoma involving breast tissue
    • Malignancy Detection: Primary screening tool for carcinoma identification; establishes diagnosis necessary for treatment planning and staging
    • Potential Complications Associated with Abnormal Results: Regional lymph node involvement, metastatic disease spread to lungs, liver, bone, or brain; systemic effects including hormonal changes if hormone-receptor positive
    • Biopsy Procedure Complications (procedural risks, not results-related): Infection, hematoma (bruising), seroma formation, scarring, nerve damage (rare), anesthesia reactions, inadequate specimen
  • Follow-up Tests
    • If Benign Result: Routine mammographic surveillance at standard intervals (annual mammogram); clinical follow-up examination; no additional testing unless imaging changes occur
    • If Atypical/High-Risk Lesion: Excisional biopsy for complete lesion removal; increased imaging surveillance every 6 months initially; consideration of chemoprevention (tamoxifen, aromatase inhibitors)
    • If Malignancy Identified (DCIS or Invasive Carcinoma): Surgical consultation for definitive treatment planning (lumpectomy or mastectomy); sentinel lymph node biopsy or axillary dissection; staging studies including imaging
    • Pathological Markers Determining Treatment: Estrogen receptor (ER) testing, progesterone receptor (PR) testing, HER2/neu testing, Ki-67 proliferation index; results guide hormone therapy and targeted therapy eligibility
    • Imaging Studies: CT chest/abdomen/pelvis, MRI breast for treatment planning (invasive cancer), PET-CT for metastatic evaluation if indicated, baseline bone scan for high-risk patients
    • Laboratory Studies: Complete blood count (CBC), comprehensive metabolic panel (CMP), tumor markers (CEA, CA 15-3) baseline; additional testing based on treatment type
    • Genetic Testing: BRCA1/BRCA2 testing if patient meets criteria; consideration of genetic counseling for hereditary cancer syndrome evaluation
    • Monitoring Frequency: Benign lesions: annual imaging; atypical lesions: every 6 months initially then annual; cancer patients: ongoing surveillance per oncology recommendations (typically 3-6 month intervals initially)
  • Fasting Required?
    • Fasting Required: No
    • Special Patient Preparation: Normal meal and hydration permitted prior to procedure; patient should wear comfortable, loose-fitting clothing for easy breast access
    • Anesthesia Requirements: Local anesthesia typically used (lidocaine infiltration); if sedation requested, anesthesia guidelines apply (NPO 4-6 hours before procedure)
    • Medications to Avoid: Anticoagulants (warfarin, apixaban, rivaroxaban) - hold 3-5 days prior or per provider instructions; aspirin and NSAIDs - discontinue 5-7 days before procedure; antiplatelet agents per cardiologist recommendation
    • Contrast/Dye Considerations: Not applicable for tissue biopsy; however, if imaging-guided procedure uses contrast (ultrasound/mammography), allergies should be disclosed
    • Imaging Requirements: Prior imaging studies (mammogram, ultrasound, MRI) should be available for radiologist review to guide biopsy targeting
    • Pregnancy Status: Inform provider if pregnant; biopsy can proceed but avoid unnecessary radiation exposure; timing may be deferred if possible
    • Allergy Assessment: Report all drug allergies (especially local anesthetics), latex allergies, and contrast allergies; provide complete medication list
    • Post-Procedure Instructions: Ice application for first 24 hours; supportive bra for comfort; avoid strenuous activity 3-5 days; resumption of anticoagulation per provider; minimal discomfort expected; some bruising normal

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