Introduction

Breast lump excision, also known as an excisional breast biopsy is larger and deeper than a shave or punch biopsy. It is used for conditions such as  cancer which must be entirely removed. Your doctor will go as deep as is necessary to remove all of the area visibly affected as well as some unaffected tissue around the outside of lesion. The incision is enclosed with some stitches.

A breast biopsy is usually performed to determine if an abnormal area or lump in your breast is cancerous. In this procedure, a tissue sample of the area of concern is removed so it can be examined by a pathologist. Breast biopsy may involve, one of three main techniques:

  • Fine needle aspiration Biopsy
  • Core needle biopsy
  • Surgical biopsy

Your doctor will choose the technique that best suits your situation.

During a fine needle aspiration biopsy, your doctor will insert a needle in your breast. Some form of guidance such as  an ultrasound probe will be used to guide the needle  to the correct area, then fluid or a small sample of tissue will be removed.

A core needle biopsy is done to remove several small pieces of tissue or cores of tissue from the breast. It may be guided using one of several techniques. During a stereotactic core needle biopsy, you will lie face down on a table with your breast inserted through a hole in the table. Your doctor will inject a local anesthetic to numb the area, then using a digital mammogram as a guide, your doctor will insert a hollow needle into the area of concern. Several small cylinders of tissue will be removed for examination. During an ultrasound guided core needle biopsy, your doctor will use an ultrasound probe to locate the area of concern. A hollow needle will be inserted to remove several cores of tissue.

Fine needle aspiration and core needle biopsies involve removing small samples of fluid or tissue, using a needle. However, if an area of concern detected by mammogram  or ultrasound is not accessible by a core needle biopsy or if your physician wants to remove the entire area, a surgical biopsy may be recommended. A surgical biopsy is done in an operating room using two techniques, i.e., Excisional biopsy and the incisional biopsy.

In the procedure of excisional biopsy, the entire mass that is affected is removed through an incision made on the breast. At the end of the procedure, the incision will be closed. Your surgeon will perform an incisional biopsy if only a small part of the area of concern needs to be removed usually to make a diagnosis. At the end of the procedure, the incision will be closed.

If the abnormality cannot be felt, needle localization will be used to mark the location of the area of concern. During this procedure, your radiologist will insert a hook wire into the breast through a needle under mammogram or ultrasound guidance. In order to mark the area, the needle will be removed, but the wire will stay in place. You will then go to the operating room where your surgeon will make an incision in the breast. He or she will follow the wire to locate the targeted area, then remove it. An x-ray will be taken of your breast to make sure the targeted area has been removed then your surgeon will close the incision.

Apollo Cradle Brookfield is an excellent choice when it comes to performing such procedures. The hospital is equipped with highly advanced technologies and tools that assist the doctors.

Causes of formation of lumps

The breast is made of layers of skin, fat and breast-tissue, all of which overlay the pectoralis muscle.

The tissue present in the breast consists of tiny ducts that carry milk and lump formation can take place among them in multiple ways.

The first kind of lump arises due to episodic chances in the breast. These periodic changes might often lead to the formation of cysts. These types of lumps can grow bigger and collapse on their own without the need of any kind of medical assistance.

Another type of lump occurs due to the elevation in the condition of the first kind of lump. In this type of lump, the size of cysts expands and as soon as you feel any kind of abnormality in your breasts, you must immediately consult a doctor.

The last type of lump takes the form of a tumor which can be cancerous or benign. When there is even the slightest doubt of the second type of lump, doctors immediately conduct tests  as well as breast biopsies to confirm the type of lump in order to decide on a treatment plan and diagnose the condition accordingly.

Sometimes, you will have breast changes that cannot be felt by physical examination alone.

How is it done?

At certain times, the doctors need to perform the excisional biopsy when the affected area can’t be spotted through a mammogram or a needle.

During the Procedure:

To perform an excisional biopsy, an elliptical incision is made and then the removal of the lesion takes place layer by layer.

The tools and equipments required for the excisional biopsy are:

  • A pair of forceps
  • A needle driver
  • Scissors for the surgery
  • A scalpel
  • A hemostat that is curved.
  • Multiple types of sutures for the closure purpose

This is the minimum requirement for the surgery, additional equipment might be needed depending upon the complexity of the surgery.

The first step of the surgery involves cleaning the area to be operated upon with some alcohol and after that the anesthesia is injected.

After the block is placed, the skin is cleansed with betadine and the area is draped to create a sterile field. The elliptical excision is made such that its longitudinal axis follows the skin lines. The skin is then excised fully through the dermis in order to obtain a full thickness biopsy. Once the ellipse is created, the tissue sample is completely removed by severing the underlying subcutaneous attachments. Short strokes are used with the 15 plate scalpel to incise down to the subcutaneous fat layer.

In order to reduce the tension along the wound while it is healing, the dermis is undermined along the lateral margins of the excision. Iris scissors are used for the purpose of undermining the margins of at least one half a centimeter larger for higher tension wounds. If the incision is large enough, then the deep tissue layers have adequate tensile strength, then a deep layer closure of absorbable suture may be used to reduce wound tension and also control bleeding if present in the deeper layer. Usually, two or three deep stitches are adequate to support the closure of small excisions.

Closure with interrupted stitches

In this case a single layer closure is performed with the needle passing through the subcutaneous layer to close the layer along with the skin surface and dermis. Simple interrupted sutures are placed to bring the wound edges together and allow healing with minimal scarring. It is good practice to evert the skin edges when passing the needle through the skin. The skin edges are everted and the needle is passed perpendicularly through the skin.

Benefits

Excisional biopsy is used when the mammogram and needle biopsies fail to locate the area of concern. Thus, excisional biopsy leaves no room for doubt. The tissue collected from the biopsy is sent for testing whether it is benign or not. If the tissue is found to be cancerous, the doctor proceeds with a surgical plan to operate out the tumor. The procedures by which the tumor can be operated are lumpectomy and mastectomy.

To avoid any sort of risk, you should visit Apollo Cradle Brookfield. The hospital specializes in dealing with cases like these. It has an outstanding team of extremely experienced and skilled doctors and technicians. Apollo Cradle has one of the best pediatrics and maternity departments. It offers amazing facilities to the patients and leave no room for complaints.

Here is a glance of the facilities provided at the hospital.

  • No Price difference between Normal Delivery & C-Section (Maternity Surgery): The hospital encourages natural/normal delivery and makes no difference between the price of a normal delivery and a c-section delivery.
  • Specialized and Delivery rooms: The hospital is highly equipped and comprised of highly specialized delivery rooms for better patient experience.
  • State-of-the-Art Ultrasound Imaging: The cutting edge ultra sound technology assists the most complicated surgeries by giving a clear picture that directs the flow of the surgeries. Surgeries like circumcision and hysterotomy require extremely focused images for the best outcome.
  • Level III NICU
  • Ventilator Equipped Ambulances: The ambulances of the hospital are also equipped with ventilators because every life is precious and it shouldn’t be lost because of delay, thus to assist patients, ambulances are equipped with ventilators.
  • Highly Trained Gynecologists and Nurses: The hospital hires the doctors and nurses with extreme care and only the most experienced, knowledgeable and skilled doctors as well as nurses are hired to avoid any kind of carelessness and ambiguity.
  • 24X7 Pharmacy: Pharmacy services are available at all times. In case you require a medicine immediately, you can purchase it from the pharmacy.
  • Range of Maternity Packages: The maternity packages at the hospital are quite reasonable.
  • Surgical ICU
  • Apollo Experts

The agenda of the Apollo Cradle Brookfield is to give 100% support to their patients and assist them in every step of the way.

To get an insight to the hospital, you can visit the official website of Apollo Cradle Brookefield that will help you make a wise decision. On the website. You will find the detailed descriptions of the procedures performed and also the reviews of the patients who have  sought health care from the hospital.

The agenda of the hospital is to encourage natural child births and avoid any sort of surgery for the delivery.