Ultrasound-guided biopsy
After local anesthesia, the doctor, under ultrasound guidance, inserts a needle precisely into the formation: with a fine-needle biopsy, cells are aspirated (quickly, for cysts and simple nodes), with a trephine biopsy, an automatic needle takes 3-5 columns of tissue - the material is sufficient for histology and immunohistochemistry (ER/PR, HER2, Ki-67 receptors), necessary for cancer to select therapy. A patch is applied to the skin, the bruise disappears in 1–2 weeks. A biopsy is indicated for BI-RADS 4–5 formations, growing nodes, suspicious cysts with a mural component, or nipple discharge. The result is discussed with a mammologist-oncologist.
Indications
- abnormal colposcopic picture, HSIL/ASC-H in cytology, HPV 16/18 with changes - cervical biopsy;
- endometrial hyperplasia by ultrasound, bleeding, bleeding in menopause, control of treatment of hyperplasia - endometrial biopsy;
- infertility, unsuccessful IVF - assessment of chronic endometritis and receptivity;
- atypical glandular cells, suspicion of canal pathology - curettage of the cervical canal;
- breast formation by ultrasound/mammography (BI-RADS 4–5) - breast biopsy.
Why is histology needed?
Only examination of the tissue under a microscope gives a final diagnosis: the degree of cervical dysplasia (CIN 1–3) or carcinoma, the type of endometrial hyperplasia (with or without atypia), chronic endometritis, benign or malignant breast formation. Tactics depend on the result - observation, conservative treatment, conization, hormonal therapy, surgery. Modern methods (pipel, vacuum and core needle biopsy, colposcopic targeted biopsy) make it possible to obtain material on an outpatient basis in minutes with minimal trauma.
