Regular Biopsy vs Excisional Biopsy? Plain English?

It's a lumpectomy, but limited--if malignant, they'd probably have to go back in and take a wider margin of tumor around the tumor and biopsy the sentinel lymph nodes as well. From least to most invasive, the types of biopsies are:

Fine-needle aspiration: for visible palpable small lumps that are more likely benign, as well as for cysts. They suck out some cells (draining an entire cyst) and analyze them under a microscope. It misses more cancers than other methods.

Core-needle biopsy: most common these days due to its high accuracy rate and relative non-invasiveness. Especially useful for masses discovered only by imaging rather than palpable lumps (but sometimes used for those as well). The tumor is located by imaging (most commonly ultrasound but often mammogram and sometimes in the case of dense breasts MRI), the target and surrounding area numbed with lidocaine (very fine needle, takes effect almost immediately), a tiny incision made, and a spring-loaded plastic "punch" device fitted with a larger (a bit biggest than used for blood donation) hollow needle takes anywhere from 5-9 "core" samples of the tumor, which are analyzed in the lab. Both types of needle biopsies are usually performed by breast-trained radiologists rather than surgeons. Both are closed with small bandages rather than sutures or adhesives+steri-strips.

Incisional: used mostly for palpable tumors near the surface that have a high likelihood of being benign. It is a type of surgical biopsy, done by a breast or general surgeon. A local anesthetic is injected. An incision is made and a small piece of the tumor cut out and analyzed. Mostly replaced by core-needle because of the latter's lower discomfort, faster healing, smaller incision and lower risk of infection. If small enough, closed by small bandage. Longer recovery time than needle biopsies (patients getting needle biopsies can often go back to work the same day and resume normal routines the next day).

Excisional: the entire visible or palpable mass is removed under general or twilight sleep anesthesia by a surgeon for lab analysis. It used to be the only kind done--a frozen section was examined before closing and waking the patient, and the only way patients knew if they had cancer was if they woke up without that breast. (The norm well into the 1970s,before it was discovered that even aggressive cancers grow slowly enough for women to weigh their options for removing tumors). Except for lack of a sentinel-node locating procedure and biopsy scar, almost as invasive as a full lumpectomy and as long a recovery time. Incision is either glued and steri-stripped or sutured. Still recommended for tumors with a high likelihood of benign status and small enough that surgeons believe they can get clear margins on the first try.

All biopsies except fine-needle can result in a seroma filling the area where the tissue was removed--nature abhors a vacuum and fills the empty space with fluid. A core-needle biopsy can produce a tiny one, and an excisional one as big as that from a lumpectomy

my surgeon explained that they use the terms lumpectomy and surgical excisional biopsy interchangeably. I took it easy the first few days after my lumpectomy, and was back to normal activities in less than a week. I had to wear a snug chest binder (that I woke up wrapped in it, in the recovery room) for 2 days, then was allowed to remove and shower with the steri strips still on. told to let them fall off by themselves in 7-10 days, saw the surgeon for follow-up on about day 10 anyway, he removed the last of the remaining steri strips and a stitch that was backing itself out. The incision was quite small to begin with (maybe an inch at most), faded quite a bit by a year, now it's been over 12 years, and I can hardly find it at all.

anne

I am glad to hear some surgeons will go wide and nodes and try to avoid another surgery. I have to have one also do to location against the chest wall and I really don't want to have it done twice.Hoping my surgeon agrees.