What info does biopsy provide?

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Angel1109
Angel1109 Member Posts: 21
edited July 2018 in Not Diagnosed But Worried

Does a mass biopsy provide info other than simply benign or malignant? I.e. if the mass is benign in terms of cancer but it's caused by say Wegener's Granulamatosis(sp?) or some other condition would the biopsy at least lend a clue there is another disease process happening? Same for a lymph node, is there any value in a biopsy if it's benign for cancer but another disease is causing the node enlargement and irregularity?


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  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited July 2018

    That's an interesting question. Perhaps our resident radiologist, djmammo, will take a crack at this one.

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  • Recap
    Recap Member Posts: 120
    edited July 2018

    I think the pathologist looks at the pathology order, and follows the institutional formula.

    I wish my pathologist had been a cowboy. I not only wanted to know what they saw on their slides, I wanted them to test for the presence of a substance. But since it wasn't in the order, I was SOL. (I had the unique experience of Vics Vapor Rub on my breast and upper leg triggering a cascade of symptoms, which I still have on the upper leg.)

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  • moth
    moth Member Posts: 4,800
    edited July 2018

    As I understand it, they don't just rule out cancer - but they may need to be specifically asked (for insurance/billing) to run different tests depending on what the ordering physician suspects. Pathologists are trained to recognize all sorts of abnormalities in cells.

    You can read this chapter of a book online on the role of a pathologist helping diagnose infectious diseases for example. https://academic.oup.com/cid/article/32/11/1589/46...

    "Carcinoma, for example, may be suspected in a patient with a solitary lung nodule and a history of long-term smoking. However, if the excisional biopsy demonstrates necrotizing granulomatous inflammation, the diagnosis of a malignant tumor is excluded and the search for an inflammatory or infectious etiology would begin. It is not uncommon for the biopsy of a pulmonary nodule, radiographically suspected to represent a malignancy, to reveal an infectious process, such as a coccidioma, a tuberculoma, or remnants of the dog heartworm Dirofilaria immitis [36, 44, 45]. In such instances, the diagnosis of an infectious disease may rely entirely on the anatomic pathologist, because, all too frequently, samples are not obtained for culture when the diagnosis of malignancy is suspected. The converse also occurs: pulmonary nodules suspected to be coccidiomas in patients from the southwestern United States, particularly from those with a serologic response to Coccidioides immitis, may be revealed to be carcinomas."


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  • Angel1109
    Angel1109 Member Posts: 21
    edited July 2018

    Thank you! The resident at the hospital where I had to take my images from the radiology center who originally did my first set of tests is saying he's not sure a biopsy is merited given my unique complex medical history. He is wondering if the bilateral axillary lymph swelling could be from one of my chromic illnesses and the solid mass in my right breast, though not explained, he is wondering if we get a better look at the margins, if we can just wait and see on it. So, he's having me redo a 3D mammogram with this hospital and an ultrasound of the lymph nodes. The whole thing makes me anxious with the wait and see approach. 1st, if chronic illness is at the heart of things bc of my present new onset of a set of symptoms since March that are unexplained by presently diagnosed illnesses, I'm thinking could there be valuable info obtained or at least the ball would get rolling with my other doctors in getting these diagnosed because cancer would be ruled out. But second, more importantly, because of my heavy family history of breast cancer, I'd rather just get the biopsy and not have to be disabled by anxiety for 6 more months worrying are they missing it and giving it time to grow. My Mom's breast cancer actually was very aggressive and 6 months would have been enough time to end her life had she had to wait from the time her mass was able to be visualized on the imaging (she ended up fighting 8 1/2 years with treatments nearly nonstop with stage 4 BC but if she had times she might ssed 1-2 weeks of chemo her breast tumor grew....her cancer was that aggressive.... Thankfully it was also more responsive to chemo for over 8 years). I just don't know. This whole process is so frustrating. I don't feel like any of the medical providers I've dealt with with the exception of the 1st Radiologist has really taken this seriously or cared about me as a person. Anyway, thanks for listening to me rant. Lol.

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  • djmammo
    djmammo Member Posts: 2,939
    edited July 2018

    Angel1109

    A core biopsy acquires enough tissue to tell you what the mass is, that is its origin, tissue type, benign or malignant and sometimes about its behavior. When a lymph node biopsy sample is sent to the path lab your history goes with it so the pathologist knows that you have diseases that affect lymph nodes in addition to something in the breast that may or may not be affecting the lymph nodes. They will then be able to choose stains and tests for the tissue that would apply to those diseases as well as what your doctor is looking for specifically.

    Let us know what the biopsy of the breast mass shows. If the nodes are shown on US to be abnormal perhaps they will biopsy one of those at the same time. Also when dealing with residents make sure their attending is in agreement with their plans.

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