Image Guided Needle Biopsy
A breast needle biopsy is generally performed to obtain a tissue sample of a suspicious finding seen on a mammogram or breast ultrasound. Generally, a needle biopsy is performed using special needle devices and imaging guidance (ultrasound or stereotactic X-ray equipment) to precisely locate the lesion. Tissue samples are removed and examined by a pathologist with a microscope. Removing and examining the tissue is the only reliable way to diagnose breast cancer.
A needle biopsy takes approximately one hour to perform, costs less than a surgical biopsy, does not require anesthesia, and does not leave scars.

Blood Test
Blood tests are performed usually to determine levels of blood proteins (such as liver enzymes) that may be abnormal if your breast cancer has spread outside of the breast to other organs such as the liver.

Chest X-Ray
A chest X-ray is performed to determine if your breast cancer has spread to your lungs.

Bone Scan
A bone scan is a nuclear medicine procedure that uses a radionuclide (radioactive substance) and special equipment called a gamma camera to image organs. The examination is performed to determine if cancer has spread to your bones (not harmful) a common site for breast cancer to spread to). The radioactive material is injected into a vein, and images of your bones are taken 2-3 hours after the injection. The time delay is needed to allow the radioactive material to clear from your body and collect in the bone. You will be encouraged to drink fluid and void frequently while you wait. 

When it is time to perform the scan, you will be positioned on the nuclear medicine equipment table under the camera detector. The radioactive material you received will transmit gamma rays that are detected by the equipment and converted into an image on a television monitor.  The equipment will slowly move over your body so all of your bones can be imaged. 

When the scan is complete the technologist will process the images and review them with a radiologist.  The radiologist will decide if the study is complete or if additional images are required. A bone scan is very sensitive and any changes, such as arthritis, fractures or infection will show up. The radiologist may request x-rays of certain areas to determine if an area seen on the bone scan is abnormal. 

A bone scan takes approximately 4 hours but most of the time is spent waiting for the material to clear your body. The test is not painful, the amount of radiation exposure is minimal, there aren’t any side effects and you will be able to resume your normal activities after it is completed. 

Sentinel Lymph Node Biopsy
A sentinel node biopsy procedure involves the injection of a tracer amount of radioisotope and blue dye around a breast tumor 3 to 4 hours prior to surgery.  The substances drain from the breast into the lymph nodes that act as filters of impurities in the body.  In the operating room, the surgeon uses a special portable radioisotope detector to find the radioactivity accumulated in the sentinel lymph node, the first node draining the tumor.  The surgeon then makes a small incision and locates the node that is discolored from the accumulation of blue dye that was injected earlier. 

The node is removed and examined by a pathologist.  If no cancer cells are present, removal of additional nodes is not required.  If, however, cancer cells are found in the sentinel node, an axillary lymph node dissection is still necessary to determine the extent of cancer spread. 
 
 

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