Core needle biopsy
Core needle biopsy is a medical procedure used to extract tissue samples from tumors that are suspected of being cancerous. This technique employs a wide-gauge hollow needle to collect samples, with specific devices like the Mammotome and Advanced Breast Biopsy Instrument (ABBI) designed for breast biopsies. The needle size typically ranges from 0.91 to 2.1 millimeters in diameter. Core needle biopsies are commonly performed on various types of cancers, including those of the breast, prostate, kidney, musculoskeletal system, and skin.
During the procedure, local anesthetic is administered, and a small incision may be made to facilitate tissue collection. Patients may undergo preparatory steps such as physical examinations and fasting for two to four hours prior to the biopsy. Post-procedure, the biopsy site is closed with sutures or Steri-Strips, and patients are monitored for a brief period. While generally safe, risks include bleeding, infection, and in certain cases, complications specific to the site of the biopsy. The tissue samples are sent to a pathologist who analyzes them for any signs of cancer, providing critical information that aids in diagnosis and treatment planning.
On this Page
Subject Terms
Core needle biopsy
ALSO KNOWN AS: Stereotactic (exact) biopsy, Mammotome biopsy, Advanced Breast Biopsy Instrument (ABBI) biopsy
DEFINITION: A core needle biopsy is a procedure in which a sample of a tumor is extracted by using a wide-gauge hollow needle, a Mammotome, or an ABBI. The Mammotome and the ABBI are used for breast biopsies only. A core needle can range in size from 0.91 to 2.1 millimeters in diameter. It has a spring-loaded device that suctions out the tissue sample. The Mammotome suctions in breast tissue and cuts it with a rotating blade. The ABBI extracts a cylinder of breast tissue about the size of the tumor.
Cancers diagnosed:Breast, prostate, kidney, musculoskeletal, and skin cancers.
Why performed: Needle biopsies are performed to obtain tissue samples from a tumor that is suspected of being cancerous.
Patient preparation: If a core needle biopsy is performed in a physician’s office, then ultrasonic guidance is used to localize the tumor unless it is palpable. If it is palpable, no radiologic guidance is required.
Needle biopsies that require the use of radiologic imaging to visualize the tumor or that are high-risk are performed in an outpatient surgical center or hospital. The preparation for these procedures may include a physical examination, blood work, and possibly an electrocardiogram (EKG). The patient would need to fast for two to four hours before the procedure.
Steps of the procedure: The patient is positioned so that the area to be biopsied is exposed. This area is then scrubbed and disinfected. A local anesthetic is injected into the area.
If the tumor is not superficial, then a small (0.125-inch to 0.25-inch long) is made into the tissue above the tumor. The core needle is inserted through the incision, and several tissue samples are taken.
After the procedure: Either a suture (stitch) or Steri-Strip (adhesive paper) is applied to close the edges of the incision. A sterile dressing is applied over the biopsy site. The patient is monitored for one hour after the biopsy.
Although core needle biopsy remains a much-used diagnostic tool, advances have been made in material and techniques. Needles with multiple cutting edges and vacuum-assisted technologies help doctors obtain more accurate tissue samples. Imaging techniques such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), which are used in conjunction with core needle biopsy, help provide greater accuracy in tissue sample location. Microscaled approaches to core needle biopsy help doctors analyze the proteins in tumors and look for genetic changes that could improve treatment outcomes.
Risks: The risks of core needle biopsy are bleeding from the biopsy site, local nerve damage, infection, and, for lung biopsies, pneumothorax (collapse of a lung).
Results: The biopsied tissue is sent to a pathologist to be examined under a microscope. The surgeon receives a report that describes the size, shape, and activity of the cells and their nuclei and states whether the tumor is cancerous.
Bibliography
“Analyzing Tumor Proteins and Genes with Less Tissue.” National Cancer Institute, 27 Feb. 2020, www.cancer.gov/news-events/cancer-currents-blog/2020/proteogenomic-core-needle-biopsy-breast. Accessed 22 June 2024.
Fisher, Cyril, Elizabeth Montgomery, and Khin Thway. Biopsy Interpretation of Soft Tissue Tumors. Philadelphia: Kluwer/Lippincott, 2011.
Jung, Chan K., et al. "2019 Practice Guidelines for Thyroid Core Needle Biopsy: A Report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association." Journal of Pathology and Translational Medicine, vol. 54, no. 1, 2020, pp. 64-86, doi.org/10.4132/jptm.2019.12.04. Accessed 22 June 2024.
Radhakrishna, Selvi, Anu Gayathri, and Deepa Chegu. "Needle Core Biopsy for Breast Lesions: An Audit of 467 Needled Core Biopsies." Indian Journal of Medical and Paediatric Oncology, vol. 34.4, 2013, pp. 252–56.
Ramsay, Alan D., Manuel Rodriguez-Justo, and Scott J. Rodig. Needle Core Biopsy of Lymph Nodes: An Atlas of Hematopathological Disease. Cambridge: Cambridge UP.
Rosen, Paul Peter, and Syed A. Hoda. Breast Pathology: Diagnosis by Needle Core Biopsy. 3rd ed. Philadelphia: Kluwer/Lippincott, 2010.
Schmidt, Leslie D. Effectiveness of Core-Needle and Open Surgical Biopsy in Breast Cancer Evaluation. New York: Nova Biomedical, 2011.
VanderLaan, Paul A. "Fine-needle Aspiration and Core Needle Biopsy: An Update on 2 Common Minimally Invasive Tissue Sampling Modalities." Cancer Cytopathology, vol. 124, no. 12, 2016, pp. 862-870, doi.org/10.1002/cncy.21742. Accessed 22 June 2024.