Breast lumps other diagnostic studies: Difference between revisions

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== Other Diagnostic Studies==
== Other Diagnostic Studies==
===Fine Needle Aspiration/Biopsy===
===Fine Needle Aspiration/Biopsy===
* '''Fine Needle Aspiration'''
====Fine Needle Aspiration====
*:* Office procedure for evaluation of palpable cyst (22-24 gauge needle)
* Office procedure for evaluation of palpable cyst (22-24 gauge needle)
*:* Bloody fluid
* Bloody fluid
*:*:* Send for cytology and refer for surgical biopsy
:* Send for cytology and refer for surgical biopsy
*:* Non-bloody fluid
* Non-bloody fluid
*:*:* Cytology extremely low yield (do not send)
:* Cytology extremely low yield (do not send)
*:*:* If mass disappears, reexamine pt in 4-6 weeks
:* If mass disappears, reexamine pt in 4-6 weeks
*:*:* If no recurrence, resume routine follow-up
:* If no recurrence, resume routine follow-up
*:*:* If recurrence, can repeat aspiration  
:* If recurrence, can repeat aspiration  
*:*:* Consider biopsy if further recurrence
:* Consider biopsy if further recurrence
*:* Non-bloody fluid but residual mass after aspiration: surgical biopsy
* Non-bloody fluid but residual mass after aspiration: surgical biopsy
*:* Solid mass (no fluid)  
* Solid mass (no fluid)  
*:*:* Surgical biopsy or fine needle aspiration biopsy
:* Surgical biopsy or fine needle aspiration biopsy
* '''Fine Needle Aspiration Biopsy (FNAB)'''
====Fine Needle Aspiration Biopsy (FNAB)====
*:* Aspiration of cells from a solid mass
* Aspiration of cells from a solid mass
*:* 21 gauge needle, operator-dependent
* 21 gauge needle, operator-dependent
*:* Wide variation in sens (65-98%), spec (34-100%)
* Wide variation in sens (65-98%), spec (34-100%)
* '''Core Needle Biopsy'''
====Core Needle Biopsy====
*:* 14-18 gauge needle allows for better histologic sample
* 14-18 gauge needle allows for better histologic sample
*:* Used mostly for evaluation of non-palpable masses (mammogram or ultrasound guidance)
* Used mostly for evaluation of non-palpable masses (mammogram or ultrasound guidance)
*:* Compares favorably with surgical biopsy at lower cost
* Compares favorably with surgical biopsy at lower cost
* '''Excisional Biopsy'''
====Excisional Biopsy====
*:* Recommended if solid mass suspicious for cancer by exam or mammo
* Recommended if solid mass suspicious for cancer by exam or mammo
*:* Also recommended for palpable mass not seen on mammogram or for abnormal biopsy
* Also recommended for palpable mass not seen on mammogram or for abnormal biopsy
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 13:56, 22 April 2013

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

Other Diagnostic Studies

Fine Needle Aspiration/Biopsy

Fine Needle Aspiration

  • Office procedure for evaluation of palpable cyst (22-24 gauge needle)
  • Bloody fluid
  • Send for cytology and refer for surgical biopsy
  • Non-bloody fluid
  • Cytology extremely low yield (do not send)
  • If mass disappears, reexamine pt in 4-6 weeks
  • If no recurrence, resume routine follow-up
  • If recurrence, can repeat aspiration
  • 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


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