什么是乳腺活检?

A biopsy is a small piece of tissue that is removed and checked in a lab. For a breast biopsy, breast tissue may be removed with a special biopsy needle. 也可能在手术中被移除. 检查是否有癌症或其他异常细胞存在.

为什么我可能需要乳房活检?

乳房活检可以做:

• To check a lump or mass that can be felt (is palpable) in the breast

• 检查乳房x光检查中发现的问题, such as small calcium deposits in breast tissue (microcalcifications) or a fluid-filled mass (cyst)

• To evaluate nipple problems, such as a bloody discharge from the nipple

• To find out if a breast lump or mass is cancer (malignant) or not cancer (benign)

A lump or other area of concern in the breast may be caused by cancer. 或者它可能是由另一个不太严重的问题引起的.

There may be other reasons for your doctor to recommend a breast biopsy.

乳腺活检的类型

有几种类型的乳腺活检程序. The type of biopsy that you have will depend on the location and size of the breast lump or area of concern.

活组织检查可在局部或全身麻醉下进行. 局部麻醉是注射药物使乳房麻木. 你会清醒，但不会感到疼痛. For general anesthesia, you will be given medicine to put you into a deep sleep during the biopsy. 

乳腺活检的类型包括:

• 细针穿刺活检(FNA). 将一根非常细的针插入肿块或相关区域. 取出一小部分液体或组织样本. 不需要切割(切口). An FNA biopsy may be done to help see if the area is a fluid-filled sac (cyst) or a solid lump.

• 芯针活检. 一根大针被引导进入肿块或相关区域. 被称为核心的小圆柱体组织被移除. 不需要切割.

• 开放(手术)活检. 乳房上有一个切口. 外科医生切除部分或全部肿块或相关区域. 在某些情况下，肿块可能很小，很深，很难发现. 然后还可以使用一种称为线定位的方法. 为此，将一根带有细线的细针插入乳房. x射线图像帮助它找到肿块. 然后外科医生沿着这条线找到肿块.

Special tools and methods may be used to guide the needles and help with biopsy procedures. 这些包括:

• 立体定向活检. With this method, a 3D image of the breast is made using a computer and mammogram results. The 3D image then guides the biopsy needle to the exact site of the breast lump or area of concern.

• 真空辅助核心活检. 乳房上有一个小切口. 通过切口插入中空管或探针. It is guided to the breast lump or mass by MRI, X-rays, or ultrasound. 乳房组织被轻轻拉入探针. 导管内的旋转刀从乳房上切下组织. 一次可以采集多个组织样本.

• 超声引导下活检. 这种方法使用乳房肿块或肿块的超声图像. 这些图像有助于将针引导到确切的活检部位.

乳腺活检有哪些风险?

所有的手术都有一定的风险. 乳房活检的一些可能的并发症包括:

• 活检部位有淤青和轻微疼痛

• 活检部位出血时间延长

• 活检部位附近感染

If the biopsy is done using an X-ray, the amount of radiation used is small. 辐射暴露的风险很低.

You may have other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the biopsy is done.

我该如何为乳腺活检做准备?

你的医生会向你解释这个过程. 问任何关于手术的问题.

• You will be asked to sign a consent form that gives your permission to do the procedure. 仔细阅读表格，如果有不清楚的地方问问题.

• 一般, you don’t need to prepare for a biopsy if your breast is numbed (local anesthesia) but you are awake. But if you are given medicine to put you into a deep sleep (general anesthesia), you must not eat or drink anything (fast) for some time before the surgery. 你的外科医生会给你具体的指示.

• 不要使用乳液, 奶油, 粉, 除臭, 或者你手臂上的香水, 腋下的, 或乳房在手术当天.

• 如果你怀孕了或者认为你可能怀孕了，告诉你的医生.

• Tell your provider if you are sensitive to or allergic to any medicines, 乳胶, 磁带, 麻醉药物(局部和全身).

• 告诉你的医生你服用的所有药物. 这包括非处方药和处方药. 它还包括维生素、草药和其他补品.

• 告诉你的医生你是否有出血性疾病的病史. Let your provider know if you are taking any blood-thinning medicines, 阿斯匹林, 布洛芬, 或者其他影响血液凝固的药物. 你可能需要在活检前停止服用这些药物.

• If you have a sedative or general anesthesia, make sure you have someone drive you home afterward. 活组织检查后你就不能开车了.

• Your healthcare provider may have other instructions for you based on your medical condition.

在乳房活检中会发生什么?

乳房活组织检查可以在医生的办公室进行. It may be done on an outpatient basis, which means you go home the same day. 也可以在住院期间进行. 有些类型的活组织检查只需要局部麻醉. 对于其他类型，需要全身麻醉. Procedures may vary depending on your condition and your provider’s practices.

通常，乳房穿刺活检遵循以下过程:

1. You will be asked to remove any clothing from the waist up, and given a gown to wear.

2. 你会躺下或坐起来. This depends on your provider’s preference and if X-ray or ultrasound guidance will be used.

3. The skin over the biopsy site will be cleaned with a sterile solution.

4. When a local anesthetic is used, you will feel a needle stick when the medicine is injected. 你可能会有短暂的刺痛感. 在该区域麻木之前，活检不会开始.

5. When ultrasound is used, the probe will be placed on your breast to find the breast lump or mass.

6. 使用立体定向成像时, you will lie face down with your breast placed in an opening on the table. A computer will find the exact site of the breast lump or area of concern.

7. 在手术过程中你需要躺着不动. 但你不需要屏住呼吸. 

8. The provider will place the needle right into the biopsy site or through a tiny cut (incision). 他或她将取出组织或液体样本. 当医生取样本时，你可能会感到压力.

9. 按压活检部位直到出血停止.

10. If needed, the opening will be closed with stitches or adhesive strips.

11. 将使用无菌绷带或敷料.

12. 这些组织将被送到化验室检查.

通常，开胸活检会遵循以下步骤:

1. 人要叫你脱下衣服，给你穿上外袍.

2. 可以在你的手臂或手上进行静脉注射.

3. 你将被安排在手术台上.

4. 可能会给你开些药(镇静剂)使你放松.

5. If local anesthesia is given, you will feel a needle stick to numb your breast tissue.

6. 如果全身麻醉, 麻醉师会继续检查你的心率, 血压, 呼吸, 以及手术期间的血氧水平.

7. In some cases, a special wire will be placed into the lump before the biopsy, guided by X-ray images. 这是为了帮助医生发现乳房肿块或肿块. 其他x射线引导的方法也可以使用.

8. The skin over the surgical site will be cleaned with a sterile solution.

9. A small cut will be made in your skin and underlying breast tissue until the lump or mass is exposed.

10. 肿块的一部分或整个肿块将被切除.

11. 用缝线或胶条缝合.

12. 将使用无菌敷料或绷带.

13. 组织将被送到实验室检查.

乳房活检后会发生什么?

How long it takes to recover will depend on the type of biopsy you had and the type of anesthesia used.

如果你做全身麻醉, 你将被带到恢复室, 你会在哪里受到密切关注. 一旦你的血压, 脉冲, 呼吸稳定，你也很清醒, 你会被带到你的病房. 不然你就回家. If the biopsy was done on an outpatient basis, you should plan to have another person drive you home.

如果你做了局部麻醉, you will be able to go home after you have completed the recovery period.

在家里

保持活检区域清洁干燥. If stitches were used, they will be removed during a follow-up office visit. 如果没有缝针的话, 您可以在指示下取下绷带或敷料, 像平常一样洗澡.

手术后，活检部位可能会疼痛数天. 按照医生的建议服用止痛药. Aspirin or certain other pain medicines may increase your chance of bleeding. 一定要只服用推荐的药物. 戴一个有支撑作用的胸罩可能有助于缓解轻微的疼痛.

You may go back to your normal diet unless your doctor advises you differently. 你可能会被告知在几天内避免剧烈的体力活动.

如果您有以下任何一种情况，请致电您的医疗保健提供者:

• 发烧或发冷

• 活检部位出现红肿、出血或其他渗出物

• 活检部位周围疼痛加重

Your healthcare provider may give you other instructions, depending on your situation.

下一个步骤

在你同意接受测试或程序之前，请确保你知道:

• 测试或程序的名称

• 你进行测试或程序的原因

• 期待什么样的结果?它们意味着什么

• 测试或程序的风险和益处

• 可能的副作用或并发症是什么

• 你在何时何地进行测试或程序

• Who will do the test or procedure and what that person’s qualifications are

• 如果你不做检查或不做手术会怎么样

• 有没有其他的测试或程序可以考虑

• 你何时以及如何得到结果

• Who to call after the test or procedure if you have questions or problems

• 你需要支付多少检查费用