Breast Cancer and Fine Needle Aspiration
Except for skin cancers, breast cancer is the most common cancer in women. The American Cancer Society estimates that in 2017, over 250,000 new cases of invasive breast cancer will be diagnosed in women. Over 63,000 cases of carcinoma in situ (CIS) will also be diagnosed. CIS is the earliest and a pre- invasive form of breast cancer. Luckily, death rates from breast cancer have been dropping, partly because of screening and early detection techniques like fine needle aspiration (FNA) biopsies.
Finding a cancer early is key to treatment and improves survival rates. You should be familiar with your breasts so you’ll be aware of changes like a painless, hard lump with irregular edges (although breast cancers can also be soft and rounded). Other possible symptoms include breast or nipple pain, swelling, skin irritation or dimpling, and thickened, red, irregular or scaly skin of the nipple or breast, sometimes called “peau d’orange” for its similarity to the skin of an orange. Regular mammograms are useful screening tools, as well. Ask your doctor how often you need one, as screening recommendations vary according to age and risk factors such as a family history of breast cancer.
What do I do if I find a lump or mass on my breast?
If a mass or lump is detected, a fine needle aspiration biopsy is often the next step. The goal of a biopsy is to remove cells so they can be examined under a microscope. An FNA biopsy is a relatively simple procedure. The doctor uses a very thin needle. The needle is inserted into the breast mass and then the material is expunged onto a slide and fixed for staining. The cells are then examined under a microscope to determine if there is cancer. The procedure is relatively quick and inexpensive compared to other methods, and it can be performed in the comfort of a doctor’s office. The results are usually available to your referring doctor within a day or two.
If you’ve found a lump or have any concerns about changes in your breasts, contact your doctor. A fine needle aspiration biopsy can quickly set your mind at ease if you don’t have cancer. If the biopsy does show abnormal cells, treatment can be initiated early, which improves your chances of recovery.
CLASSIFYING BREAST CANCER
Classification of Breast Cancer Malignancy Using FNA Biopsies
Classification of Breast Cancer Malignancy Using FNA Biopsies
The classification of breast cancer is a vitally important issue for any woman facing a breast cancer diagnosis. Classification indicates how far the cancer has progressed, which affects treatment decisions and long-term survival rates. A fine needle aspiration specialist can use this biopsy technique to help make an early diagnosis and classification, speeding up the time between diagnosis and treatment.
Breast cancers can be classified in different ways. For the best and most complete classification, the pathologist should include the histopathology, grade, stage and receptor status. DNA classification can also be important.
What are the different stages of breast cancer?
- Histopathology has to do with the source of the breast cancer cells and the tissues which are invaded.
- Grade is a comparison of the cancer cells to normal breast tissue. Cancer cells progressively lose the features of normal cells (become less differentiated). High grade or poorly differentiated cancers have a worse prognosis.
- Staging refers to where the cancer started in the body and where it has traveled since then. For example, breast cancers that have spread (metastasized) to the lymph nodes or more distant areas like bones or the liver have a worse prognosis.
- Receptors are located in various areas of the cells, where chemical messengers like hormones bind to the receptors and cause changes in the cells. Breast cancer cells may be receptive to hormones like estrogen and progesterone, which can affect treatment strategies.
- DNA in the cancer cells can show the presence of genetic mutations, which can guide treatment or help identify which treatments are most likely to be effective.
BREAST CANCER BIOPSY WITH FNA
Did you know that the tissue in your breast’s density level is critical to understanding how at-risk you are for developing breast cancer? Also, more than half of half of the women in the United States have dense breast tissue. Breast tissue density falls into four categories:
- Predominantly Fatty (0 to 25-percent fibroglandular tissue)
- Scattered Fibroglandular (25 to 50-percent fibroglandular tissue)
- Heterogeneously Dense (50 to 75-percent fibroglandular tissue)
- Extremely Dense (greater than 75-percent fibroglandular tissue)
If you have denser breast tissue, your doctor may recommend fine needle aspiration of the breast for a closer look. This is because more dense breast tissue makes it harder for your doctor to detect early breast cancer signs.
Instead of relying on images through a mammogram, a FNA collects tissue samples. Where early breast cancer lumps and fibroglandular tissue look very similar, they differ at a cellular level. These differences are generally easy for your doctor to see, and it can help get earlier detection.
Early detection is extremely important when it comes to breast cancer because it can spread and advance if you mistake it for something harmless like fibroglandular tissue or a benign lump.
Early Detection For Breast Cancer
Make an Appointment with Dr. Nadelman
Early detection is very important and can sometimes be the difference between life or death. If you notice that something is off with your health or you experience any of these symptoms, play it safe and make an appointment to discuss your concerns with your doctor. Paying attention and knowing your body not only helps with early breast cancer detection, but also other underlying medical conditions that could be affecting your daily life.
Talk to your doctor today about FNA for breast cancer so they can refer you to our clinic. Breast Cancer can’t wait.
WHAT IS THE BEST OPTION FOR BREAST CANCER BIOPSY?
An FNA biopsy is one of the choices for making a breast cancer diagnosis. Quick, relatively easy and typically less expensive than other strategies like an open biopsy, an FNA biopsy can often deliver an answer within a day or two. A fine needle aspiration specialist can perform the test in his or her office, and the cells can be immediately examined under a microscope. The procedure does not require extensive preparation and down time is not usually necessary. FNA biopsy makes breast cancer classification faster.
When you arrive at your fine needle aspiration of the breast, your doctor will sterilize the area and ask you to relax. They’ll then insert a very thin and hollow needle into your breast to get to the lump. Once they get to the lump, they’ll extract a small amount of cells up through the needle and into a collection area.
These samples get sent off to the lab for testing. They may use an ultrasound to guide the needle, but it’s not always necessary. You’ll get your results in a few days after having the procedure. It’s minimally invasive, and people are usually back to their normal routines quickly.
FNA can help to save lives by helping doctors tell the difference between simple fatty tissue and a cancerous lump. Additionally, FNA is a way for doctors to test very small lumps and catch the cancer in the very early stages. This is excellent news because the earlier the cancer gets caught, the better the outcome.
Dr. Celina Nadelman, M.D., is one of very few doctors in the U.S. to uniquely serve as both a board certified cytopathologist and a fine needle aspiration (FNA) specialist. In addition to operating her own FNA clinic and in-office laboratory practice in Beverly Hills, California, Dr. Nadelman performs the same dual-role services at Los Angeles County’s Martin Luther King, Jr. Outpatient Center, and is also a clinical instructor at UCLA’s David Geffen School of Medicine Greater Los Angeles Training Cytotechnology Consortium.
CELINA NADELMAN, M.D.
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