Breast lumps other diagnostic studies: Difference between revisions

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== Other Diagnostic Studies==
== Other Diagnostic Studies==
===Fine Needle Aspiration/Biopsy===
Biopsy
====Fine Needle Aspiration====
 
* Office procedure for evaluation of palpable cyst (22-24 gauge needle)
The only certain method to approve the presence of breast malignancy is breast lump biopsy <ref> John M. Eisenberg Center for Clinical Decisions and Communications Science. Having a Breast Biopsy: A Review of the Research for Women and Their Families. 2016 May 26. In: Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK368364/ </ref>
* Bloody fluid
 
:* Send for cytology and refer for surgical biopsy
 
* Non-bloody fluid
There are three types of biopsy <ref> John M. Eisenberg Center for Clinical Decisions and Communications Science. Having a Breast Biopsy: A Review of the Research for Women and Their Families. 2016 May 26. In: Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK368364/</ref>
:* Cytology extremely low yield (do not send)
 
:* If mass disappears, reexamine pt in 4-6 weeks
*Fine needle biopsy <ref> Casaubon JT, Regan JP. Breast Masses, Fine Needle Aspiration. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470268/</ref>
:* If no recurrence, resume routine follow-up
*Core needle biopsy
:* If recurrence, can repeat aspiration
*Open surgical biopsy
:* Consider biopsy if further recurrence
* Non-bloody fluid but residual mass after aspiration: surgical biopsy
* Solid mass (no fluid)
:* Surgical biopsy or fine needle aspiration biopsy
====Fine Needle Aspiration Biopsy (FNAB)====
* Aspiration of cells from a solid mass
* 21 gauge needle, operator-dependent
* Wide variation in sens (65-98%), spec (34-100%)
====Core Needle Biopsy====
* 14-18 gauge needle allows for better histologic sample
* Used mostly for evaluation of non-palpable masses (mammogram or ultrasound guidance)
* Compares favorably with surgical biopsy at lower cost
====Excisional Biopsy====
* Recommended if solid mass suspicious for cancer by exam or mammo
* Also recommended for palpable mass not seen on mammogram or for abnormal biopsy


==References==
==References==

Revision as of 14:37, 12 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Other Diagnostic Studies

Biopsy

The only certain method to approve the presence of breast malignancy is breast lump biopsy [1]


There are three types of biopsy [2]

  • Fine needle biopsy [3]
  • Core needle biopsy
  • Open surgical biopsy

References

  1. John M. Eisenberg Center for Clinical Decisions and Communications Science. Having a Breast Biopsy: A Review of the Research for Women and Their Families. 2016 May 26. In: Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK368364/
  2. John M. Eisenberg Center for Clinical Decisions and Communications Science. Having a Breast Biopsy: A Review of the Research for Women and Their Families. 2016 May 26. In: Comparative Effectiveness Review Summary Guides for Consumers [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK368364/
  3. Casaubon JT, Regan JP. Breast Masses, Fine Needle Aspiration. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470268/


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