The morphological diagnostics play an important role in the management of breast gland pathologies, among which biopsy methods remain one of the main tools for diagnosing breast diseases, particularly neoplastic formations.

The essence of biopsy

Breast biopsy is a minimally invasive surgical procedure aimed at obtaining tissue or cellular material from a suspicious formation for further histomorphological and cytological examination. The results of the biopsy are crucial in determining treatment tactics and assist in proper therapeutic planning.

1. Core Needle Biopsy (CNB)

COR biopsy is currently considered one of the most reliable, informative, and standard methods for the diagnosis of breast formations. The procedure is performed:

• With local anesthesia

• Under ultrasound guidance

• With a special automated biopsy device

The patient is placed in a supine position. A small incision of 2–3 mm is made on the skin surface, through which 3–6 tissue samples are taken using a special instrument. The material is sent for histomorphological and immunohistochemical examination.

Additionally: In cases where the patient requires neo-adjuvant chemotherapy, a metal clip is implanted in the cancerous area during the biopsy process for subsequent marking.

Procedure: It is performed on an outpatient basis, lasts on average 20–30 minutes, leaves no scar, and does not require hospitalization.
The diagnostic accuracy of COR biopsy reaches 98%.

 Specific form:
In cases where the formation is visualized only by mammography or MRI, the biopsy is performed using the stereotactic method (Stereotactic Needle Biopsy).

2. Fine Needle Aspiration (FNA)

FNA biopsy is performed with a standard needle, under local anesthesia and under ultrasound guidance, without an incision in the skin.

Its advantage is minimal invasiveness and technical simplicity, yet diagnostic accuracy and depth of information are limited, as only cytological material is obtained, making it impossible to accurately determine morphological and immunohistochemical types.

📌 Uses:

• Investigation of cystic formations

• Assessment of metastatic lesions in regional lymph nodes

3. Incisional biopsy

Incisional biopsy is performed openly, under local anesthesia conditions. The surgeon takes a tissue sample from the cancerous area through a small incision.

📌 It is used when other types of biopsy are less informative or when the cancer is invasive in the skin.
Despite its informativeness, incisional biopsy does not represent an alternative to COR biopsy in cases of palpable or radiologically described lesions.

4. Excisional biopsy

Excisional biopsy is a complete surgical operation aimed at completely removing the suspicious area for diagnostic purposes.

📌 Performed under general anesthesia or extensive local anesthesia

📌 Characterized by high diagnostic accuracy and does not yield false positive results

📌 Used only selectively, when other methods are not available or adequate