Breast Cancer Diagnosis
Cancer as we all know is an uncontrolled proliferation of cells and this happens because of damage to DNA within the cell. The DNA damage could be of any cause, but the changes within the DNA and characteristics of the cancer cells are specific that they can be identified easily by a pathologist. These changes are almost similar to all cancers. This applies to breast cancer too and after the surgeon takes out representative cells from the breast lump, the pathologist examines them under the microscope to diagnose the presence of cancer.
The representative cells and tissue is obtained by a surgical procedure called Biopsy and there are several techniques of biopsy. Accurate diagnosis is critical for developing an effective treatment plan.
FNAC
A thin needle is used in this method to obtain cells from the breast lump. If the lump is not palpable and detected in screening tests like mammogram, an ultrasound might be used to localize the lesion and the needle is guided to the lesion to collect the cells. As the needle is thin it is not possible to obtain intact tissue and cells are collected.
This is a simple almost painless test done in Outpatient setting and takes around 5 minutes. The report takes few hours to be generated and based on the report further tests might be ordered.
Trucut Biopsy
In this method, a larger needle is used and hence a small cut is made on the skin. So it is usually done after giving local anaesthesia. This test is also done in the outpatient setting and patient can home immediately. Unlike FNAC, tissue is obtained and the reporting takes longer time- around 3-4 days.
Trucut biopsy is the gold standard for breast cancer diagnosis and treatment decisions can be made on this investigation.
Incisional Biopsy
When repeated Trucut biopsies are inconclusive and pathologist is expecting a larger tissue for diagnosis, the surgeon under general anaesthesia makes a bigger incision using scalpel takes a big chunk of tissue or sometimes the tumor is removed if it is relatively smaller.
Vaccum Assisted Biopsy
This is a modern technological advancement that combines the incisional biopsy with Imaging technology. The device has a built in Imaging technology that allows localizing the lesion while the device is inserted after making a small incision. The rotatory cutting device carefully cuts the breast tissue and the lesion and sucks the tissue into a chamber that is delivered to the pathologist for diagnosis. This is a diagnostic and also treatment technique often used to manage non palpable lesions of the breast.
Frozen Biopsy
Traditional biopsy reporting takes few days to report the presence or absence of cancer. As a result patient has to undergo a second surgery after the final report is delivered and if it proves the presence of cancer.
A modern method of reporting is developed and called FROZEN BIOPSY. In this method, while the patient is still under the anaesthesia, the surgeon removes the tumor or piece of it and sends it to the lab. The pathologist uses a deep freezer to freeze the tissue and takes extremely thin slices of this tissue enabling him to examine under the microscope. This method is commonly used by the experts of Hyderabad Breast Clinics to decide the treatment plan and avoid the discomfort of second surgery for the patients.
In the management of Breast Cancer the first and most crucial step is establishing the presence of cancer and the type of cancer. The Diagnosis of Breast cancer encompasses several subtypes and each type has its own behaviour and treatment plan.
Molecular Testing
One of the biggest advancements in breast cancer care in the recent past has been the IHC molecular testing. This test is done on the tissue that is removed from the target lesion. This test identifies and classifies the breast cancer into several subtypes (ER+, PR+, HER2Neu + and so on). Based on these test results patients are classified into Hormone receptor positive and such tumors can be managed using Hormone therapy to reduce the risk of recurrence. Further we also understand hormone positive tumors do better than Hormone negative cancers. Similarly tumors which are Her2Neu positive are aggressive and need additional treatment like Trastuzumab – A immunotherapy molecule.
- About US
- Contact Us
- Gallery