Results from a clinical study found that middle-aged women undergoing routine breast biopsies who were given an emotionally supportive caregiver were able to complete the procedure and report no significant change in their overall psychological distress after a procedure.
Micki Ewen’s case was featured on Dr. Phil’s show “You’re Not Alone” and she spoke at an event in Washington D.C. in 2014, one day before she died from her debilitating illness. She is a remarkable woman whose spirit and determination will inspire us all.
Sadly, there’s a dearth of knowledge about how to prepare patients and their loved ones for the emotional and psychological impact of a biopsy. The challenges of caring for people with chronic pain have recently been acknowledged by researchers who estimate that more than 2 million Americans suffer from the condition. In this article, I’ll focus on the physical aspects of cancer biopsy, and how to prepare for this procedure.
A woman’s breasts can change during her life due to menopause or other changes and undergo minor changes due to normal hormonal fluctuations. However, the typical woman is most likely to get breast cancer in her 40s and 50s, well before menopause. In these instances, women may require a biopsy to diagnose breast cancer.
The best way to prepare for a breast biopsy is to prepare mentally. Have the right attitude about the procedure and treat the preparation for the biopsy as a normal medical procedure.
What happens during a breast biopsy?
Your doctor may want to remove a few fibrocystic lesions on the breast. Fibrocystic lesions look like clumpy or hard patches of tissue. Most often, they are harmless, but fibrocystic lesions can indicate a cancer, but they also can be benign.
A single biopsy does not definitively determine a positive biopsy. Your doctor may need to send slides from several specimens for analysis.
How is a biopsy performed?
The procedure generally involves sending thin slides or a needle with a numbing agent directly into the lesion(s).
How long will the biopsy take?
The vast majority of biopsies will require a minimum of 30 minutes to complete, so if you’re not required to be under anesthesia, expect to wait a maximum of 3 hours to have your results.
How will I feel after a biopsy?
After the biopsy, a small amount of tenderness may remain. Also, your breasts may be swollen. This is just residual swelling resulting from the procedure.
If a biopsy is done with local anesthesia, you may feel a bit of tenderness for a few days afterward. In most cases, you will not be required to be under anesthesia for a biopsy.
What is the difference between a routine and a mammogram?
A routine mammogram is a mammogram performed while the patient is lying down. The breast is photographed from several different angles using a mammogram machine. The results can be printed and discussed with the patient.
A mammogram may or may not find a tumor that may need to be removed by a biopsy.
If the scan reveals an abnormality, a breast biopsy may be performed.
If the biopsy results do not show any abnormalities or are inconclusive, no further action is needed.
What will I need to bring to my biopsy appointment?
If you are being told that you will need to be under anesthesia, you will need to drink a small amount of water an hour before the procedure. Do not drink anything else.
During the procedure, you will need to remove your clothing and any jewelry, and put on a hospital gown. You will be asked to leave your bra, necklace, or earrings on.
At your appointment, bring the following items:
- A list of all medications and supplements taken
- If you are pregnant, bring a note from your doctor indicating the potential risks to your pregnancy
- If you are breastfeeding, bring a note from your doctor indicating that you are not breastfeeding and that you are on medications that can affect your milk supply
How do I prepare for a breast biopsy?
Follow your doctor’s instructions to prepare for your biopsy. Generally, this means taking your medications on time, taking iron supplements, and avoiding foods that may trigger a bad reaction such as caffeinated beverages.
If you are diagnosed with breast cancer, your doctor may tell you that a biopsy is necessary. In that case, make certain to arrive for the procedure in plenty of time.
After the biopsy, you will likely be provided with instructions regarding next steps. Depending on the circumstances of the biopsy, you may need to return for additional procedures. This can involve a needle biopsy or a computer tomography (CT) breast exam. For more information on a biopsy, visit the
What should I expect after a biopsy?
The doctor will make a diagnosis based on the medical findings during the biopsy. This diagnosis will include any suspected cancer and additional examination to confirm the biopsy results.
After the diagnosis is made, you may be required to undergo additional medical treatment, as directed by your doctor. You will also be referred to a surgeon for treatment.
Because the results of a biopsy may be unclear, additional medical testing is usually recommended. This may include a blood test and imaging scan to look for additional cancer.
What tests are recommended following a biopsy?
The doctor will order additional testing to look for additional cancer if there is any.
If your breast tissue was removed for a biopsy, you may be instructed to follow up with a needle biopsy. This will examine small amounts of tissue to look for any remaining cancer.
After a biopsy, a medical oncologist may recommend a breast ultrasound, MRI or CT scan to look for any remaining cancer.
If your breast tissue was not removed for a biopsy, a medical oncologist will typically order imaging tests and blood tests. The imaging tests are usually CT scans or MRIs to look for a recurrence of breast cancer or the presence of additional cancer.
After the biopsy, an oncologist will usually recommend that you be followed for a few months by a doctor who specializes in treating breast cancer. This doctor will review your results and may recommend that you have additional testing done.
If you decide that you want additional treatment, you will usually need to follow up with a medical oncologist. These doctors can help you decide whether you need chemotherapy, radiation therapy or surgery.
What is the role of breast cancer screening?
For most people, breast cancer is not a life-threatening disease. Most patients can and do live long lives following diagnosis with breast cancer.
However, if a cancer is diagnosed early, it is less likely to spread, which is called the stage 0/1 staging. It is therefore recommended that everyone undergo routine screening, as per the recommendations of the US Preventive Services Task Force (USPSTF). This recommendation applies to women 40 years and older who are not at increased risk for breast cancer.
In the UK, the screening recommendations are similar to the USPSTF recommendations.
What causes breast cancer?
In most cases of breast cancer, it is the immune system of the body that triggers the growth of cancer cells.
To understand the cause of breast cancer, we first have to understand the role of the immune system.
The immune system is the body’s first line of defense against infection. In normal healthy people, the immune system defends the body against bacteria, viruses, and other pathogens that can cause infection.
In some cases, however, the immune system can go awry, mistakenly attacking normal, healthy tissues in the body, such as the breast. This is known as autoimmune breast cancer (IBC).
The cells of the immune system usually communicate with one another by making specific chemical signals. One type of signal is called cytokines. These signals play an important role in signaling the immune system to fight an infection or pathogen.
When the immune system makes the wrong type of signal, it causes inflammation, which can damage healthy tissues.
This causes cells in the breast to be inflamed and grow into abnormal shapes that may be called tumor cells.
In many cases, IBC is caused by either a combination of IHC and HHC: IFN-γ + IHC (IFN-γ + HHC).
Symptoms of IBC include:
- difficulty breathing
- swollen glands
A woman with IBC may feel these symptoms at any time, regardless of where the tumor is located in the body.
Women with IBC should see their doctor promptly if they experience any of the above symptoms.
How is IBC diagnosed?
The first step in diagnosis of IBC is the medical history. A physical examination can reveal any possible symptoms of IBC.
The next step is the analysis of the tissue to determine the type of breast cancer. If it is thought that the tumor may be IBC, a doctor may conduct a needle biopsy to collect tissue samples.
These samples are examined under a microscope and can identify which cells of the immune system are damaged or abnormal in the tissue.
The tissue is examined under a microscope, which can determine whether the abnormal cells are cancerous.
However, many different types of tissue must be examined, depending on the type of IBC being diagnosed.
For example, IFN-γ + HHC breast cancer is a tumor that contains immature cells (cells that look like cancer cells). Some of these abnormal cells may appear normal, even in normal tissue, so abnormal cells in normal tissue, or in the breast are required for an accurate diagnosis of IBC.
Another type of abnormal cell that is typical of IHC breast cancer is growth of lymphocytes. Lymphocytes are the white blood cells that fight off viruses and other infections.
The best way to diagnose IBC is with a sentinel lymph node biopsy, in which a biopsy is taken of a specific area of the body.
There is a test that looks for the presence of lymphocytes. However, there is no way of determining whether the cells are cancerous or not without using a biopsy.
If a person has a medical history of breast cancer, especially with a lump or nipple abnormalities, it is recommended to have an MRI scan.
If the cancer has spread, the chest X-ray is also recommended. However, if a lump or nipple changes have not spread, a mammogram is not recommended for diagnostic purposes.
How is IBC treated?
IFN-γ + HHC breast cancer is treated with surgery to remove the affected tissue.
It is possible to treat the other types of breast cancer, but the treatment options differ depending on the type of breast cancer and the risk of the cancer returning.
If the cancer is IFN-γ + HHC, a doctor may recommend chemotherapy to target the abnormal cells. The type of chemotherapy used will depend on the tumor characteristics and the woman’s response to treatment.
Treatment options for IFN-γ + HHC include:
- radiation therapy
If IHC is treated with chemotherapy, many women experience an improvement in their symptoms, but some women experience no changes.
In some cases, surgery is not successful, or even becomes detrimental, for women who have IHC. It is, therefore, important to recognize this potential complication when deciding whether to have IHC breast cancer treatment.
However, if the tumor is IHC, treatment can be successful. A doctor will look to remove the tumor as well as remove any precancerous growths.
In some cases, the immune system may fail to respond to treatment. If this is the case, a person may require other therapies to treat the cancer, or the tumor may regrow.
In rare cases, there may be a small chance of the cancer returning after treatment. However, this does not occur in 90 percent of cases.
What causes IBC?
It is not known why IBC occurs in approximately 15 to 20 percent of cases.
Some women with an inherited gene called BRCA1 are at a higher risk of developing this type of cancer.
Other risk factors for IBC include:
- poorly controlled diabetes
- being post-menopausal
- Black Americans have shown higher instances of IBC
Having an illness that affects the immune system, such as a cold or flu, can also increase the risk.
How is IBC treated?
Medications that suppress the immune system may be used to treat IBC. Medications that suppress the immune system may be used to treat IBC.
Medications that suppress the immune system are commonly used to treat IBC. These medications are usually taken for a short time, usually 5 to 7 days.
Most of the time, the side effects are mild.
Breast cancer medications are divided into three categories:
1. Antibiotic therapies
Some of the antibiotics used to treat IBC include:
- aminosalicylates, such as clarithromycin
- beta-lactam antibiotics
Many breast cancer patients also take the antiviral medications, such as acyclovir, vorinostat, and famciclovir. These also suppress the immune system.
2. Hormone therapies
Some women receive hormone therapy as part of their treatment. These treatments include:
3. Radiation therapies
The treatment of IBC with radiation is also an option for some women. These treatments are usually carried out on an outpatient basis, and a woman will usually spend one day in the hospital.
The types of radiation used to treat IBC vary. Low-intensity radiation therapies are often used in combination with a chemotherapy regimen.
High-intensity radiation therapies are typically used alone or in combination with a chemotherapy regimen.
Chemotherapy is not always recommended for IBC patients, as the medication can affect the immune system. If the cancer returns, a doctor may have to use other types of treatments to treat the cancer.
The chemotherapy used for IBC is sometimes very strong and will have to be used for a longer period of time than is necessary. A doctor will usually discuss the benefits and possible risks of chemo with the patient and their doctor.
When to see a doctor
If any of the symptoms of IBC are significant or interfere with daily activities, a person should speak to their doctor.
Also, the doctor will check that a person’s medical conditions are fully under control before starting the treatment.
A woman who has been pregnant, or is breastfeeding, should not start treatment for IBC until after they have stopped breastfeeding or started again.
Causes of IBC in pregnancy
Taking a pregnancy test in the first trimester of pregnancy can help detect IBC. Taking a pregnancy test in the first trimester of pregnancy can help detect IBC.
In about 15 to 20 percent of women with IBC, they will develop IBC during pregnancy.
As a result, a doctor may recommend avoiding invasive treatment for IBC until the pregnancy has ended. Some treatments, such as surgery, can have a harmful effect on a fetus.
In these cases, a doctor may prescribe an anti-inflammatory medication and recommend that women avoid taking any medications that cause inflammation, such as ibuprofen.
Pregnancy tests, along with genetic testing, can help diagnose IBC. A blood test for a protein called EW7, which is often elevated in women with IBC, can help diagnose the condition.
These tests are usually only offered to women who have already been diagnosed with IBC.
How is IBC diagnosed?
In cases of IBC that are detected in early stages, a doctor can diagnose the condition based on symptoms alone. However, sometimes the tumor will not show any other symptoms and a doctor may need to order tests.
In rare cases, it may be possible to diagnose IBC by testing cells from a tumor under a microscope. However, the tests are expensive and not widely available.
Diagnosis can also be tricky for cases of IBC that have spread to other areas of the body.
When to see a doctor
A doctor may recommend that a woman with IBC see a specialist or go to the emergency room if the following symptoms occur:
- a new rash
- loss of sensation in the legs or feet
- blurred vision
- trouble urinating, however, these symptoms often disappear without treatment.
IBC is a serious condition that often affects older adults. However, it can affect women in their 20s and 30s, as well as those who are pregnant or breastfeeding.
It is not known exactly what causes IBC. Some researchers believe that this is due to an abnormal immune system.
Despite the seriousness of IBC, there are many different treatments that can help treat it.
Doctors will usually take a person’s medical history into account when they are planning treatment options.