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Biopsy Recommendations

There are many different types of biopsies, but you need to start with one. So, you may be wondering why one test is recommended instead of another.

Well, it depends on the mass.

Why dig up the whole flowerbed if you only need a small piece of the leaf? A gardener will choose the best tool for the job, causing the least amount of harm to the garden. Like a gardener, your doctor will choose the best biopsy for your case.

If the doctor suspects the mass is a cyst(CIST) — A small enclosed collection of fluid (a benign(BE-NINE) — A growth in the body that is neither invasive nor cancerous and has a very low risk of spreading, fluid-filled cavity) then a fine needle aspiration (FNA)(FINE NEE-DOL AS-PER-A-SHUN) — The withdrawal of fluid or tissue from the body with a needle may be conducted first. This is because an FNA can easily be performed in your doctor’s office to see if the mass is full of fluid and likely benign. Since this test only collects a few cells, the sample usually is not large enough for the doctor to make a cancer diagnosis. But, it is very helpful in determining if the mass is a tumor(TOO-MER) — Abnormal growth in the body (solid) or a cyst (fluid-filled). If the mass remains suspicious, your doctor is likely to recommend another biopsy that collects a larger tissue sample.

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The needles used for core needle, ultrasound-guided, stereotactic, and MRI-guided biopsies are essentially the same. The larger needles can collect more tissue, allowing the doctor to do more tests on the sample. Occasionally, a core needle biopsy(CORE NEE-DOL BYE-OP-SEE) — Removal of tissue using a large needle can be done in your doctor’s office, but only if the mass can be easily located and held in place.

The decision between an ultrasound-guided, stereotactic, or MRI-guided biopsy is mostly influenced by the technique that will best visualize the mass. If the mass is easily seen with x-rays(EX-RAYS) — Energy particles that pass through tissue to obtain an image of the body (mammogram(MAM-O-GRAM) — A screening test that uses x-rays to look for breast cancer), then a stereotactic biopsy(STAIR-E-O-TAK-TIC BYE-OP-SEE) — A technique using x-rays to guide the placement of a needle in order to obtain tissue is the most common technique. But if an ultrasound(ALL-TRA-SOUND) — An imaging technique that uses sound waves to differentiate types of tissue can see it better, then an ultrasound-guided biopsy(ALL-TRA-SOUND GUY-DID BYE-OP-SEE) — A technique that uses sound waves to direct the placement of a needle in order to obtain tissue will probably be recommended. Ultrasound-guided and stereotactic biopsies are the most commonly used techniques. MRI-guided biopsies are recommended when the mass is only visible on an MRIA loud banging machine that uses magnets to obtain pictures of the inside of the body; magnetic resonance imaging.

If the biopsy’s results do not match what the doctor predicted, then an excisional biopsy(EX-SIZ-SHUN-OL BYE-OP-SEE) — Surgical removal of a larger piece of abnormal tissue or an entire small mass is often needed to make a diagnosis. The excisional biopsy should give the doctor enough tissue to examine to determine if the tumor is benign, premalignant(PRE-MA-LIG-NENT) — A growth that will worsen and grow into a cancer, becoming malignant if not removed, or malignant(MA-LIG-NENT) — A cancer or abnormal tumor that grows uncontrollably and may spread to other parts of the body, as well as better classify the mass.

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