Ultrasound-guided Core BiopsyMedical editor Marit Muri Holmen MD
Oslo University Hospital
Ultrasound-guided core biopsy is utilized for diagnosing inconclusive findings in the breast, either as an independent method or as a supplementary examination after a fine needle biopsy. In most breast diagnostic centers, core biopsy is preferred as a diagnostic method before breast cancer surgery.
There is an indication for core biopsy if the cytology result does not provide a conclusive diagnosis, or if there is lack of agreement between cytology results, image diagnostics, or clinical examination.
- Special analysis of a known malignant lesion
- To conclude whether a lesion, palpable or non-palpable, is benign or malignant.
- Ultrasound apparatus
- Local anesthesia
- Biopsy gun
- Needles (14G and 16G)
- Local anesthesia is injected through a thin needle.
- It is important that the patient is able to lie still during the examination. The patient must be informed that the biopsy gun gives a moderate crack when the sample is taken to prevent her from spontaneous movement.
- Ultrasound-guided core biopsy may be performed regardless of anticoagulation treatment.
The examination is performed aseptically.
- The lesion is localized by means of ultrasound.
- The breast is disinfected.
- Local anesthesia is applied.
- An incision is made for the puncture.
- The biopsy needle is inserted onto the lesion during ultrasound guidance.
- When the gun is “fired”, the needle thrusts 22 (or 15) mm forward, first the core needle then the external casing.
- The biopsy remains in a notch in the core needle.
- Usually 1-3 samples are taken.
- The area of puncture is compressed after the biopsy is taken.
- Patients on anticoagulation are observed up to 30 minutes after the procedure.
- The incision is bandaged.
The patient can go home after the procedure.
The patient should:
- Observe the puncture point for possible bleeding
- Minimize physical activity and should not lift heavy objects or do sport activities the same day
- Wait until the next day to shower
Pain reducing drugs such as paracetamol should be used as needed (no salicylate drugs).
Results are usually available in 4-7 days.