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What information is determined from a breast tumor biopsy?

Dennis L. Citrin, MD
Hematology & Oncology

A breast tumor biopsy will first indicate if a patient has cancer or not. The breast tumor biopsy also provides information on the biology of the cancer, by measuring estrogen receptor, progesterone receptor, Her2 neu and also studies of the genetic make-up of the cancer (genomic studies). These provide essential information for planning treatment.

Shelby A. Terstriep, MD
Hematology
The first is what cell type and whether it is cancerous.
If it is cancerous, grade is another feature which may give us a sense of how fast the cells may be dividing. The pathologist will also do special testing to determine if the cells are "fed" by estrogen and progesterone. In addition the pathologist will evaluate if the tumor is overproducing the Her 2 neu protein.
Elisa R. Port, MD
Surgical Oncology
When an abnormality is found either on physical examination (such as a lump) or on imaging tests (such as a mammogram or ultrasound) a biopsy is recommended. The standard of care is to perform a needle biopsy when at all possible. A biopsy can make the distinction between normal and cancer and guides additional decisions regarding treatment. If a biopsy provides results that show that the area of concern is, in fact, normal, often no further treatment is required. if instead the biopsy identifies the cancer, these results guide decision making and recommendations.
Sometimes needle biopsy results are not definitive, and in such cases removal of the area is recommended just to be sure nothing concerning was missed by the biopsy. But needle biopsies are quite accurate and can successfully provide accurate information in the vast majority of cases.
Steven G. Eisenberg, DO
Hematology & Oncology

We learn so much from the pathology report after the biopsy is completed. First of all, is there cancer and if so, what type of breast cancer. We learn the size of the invasive cancer, whether there was ductal carcinoma in-situ (non-invasive cancer), the grade (a measure of aggressiveness), whether there was invasion into the tiny lymphatic channels and blood vessels, and whether the margins were free of cancer (for a lumpectomy). Also, and this very important, we learn if the cancer expresses ER (estrogen receptor), PR (progesterone receptor), and Her-2 neu (a marker that tells us if the patient is a candidate for Herceptin). All of this information helps us to determine the best treatment approach in terms of further surgery, chemotherapeutic options, endocrine therapy options and radiation necessity.

Ajay K. Sahajpal, MD
Transplant Surgery
A breast biopsy can help determine if the lesion being biopsied is benign, malignant or premalignant and the degree of differentiation if the biopsy confirms cancer.
Needle biopsies of breast tumors are useful for, first of all, confirming the clinical diagnosis of breast cancer. For breast cancer tumors, the "grade" of the tumor (i.e. how aggressive it appears under the microscope), the subtype of breast cancer, the presence or absence of chemical receptors for estrogen and progesterone (the "female hormones"), and the presence or absence of a genetic abnormality called HER-2/neu are all routinely evaluated by needle biopsies. If the tumor is completely excised by a surgeon, the size of the tumor can also be assessed (tumor size is an important part of breast cancer staging).
Robert A. Wascher, MD, FACS
Author, "A Cancer Prevention Guide for the Human Race"
www.doctorwascher.com
 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.