ABSTRACT The explosion in technol...

ABSTRACT

The explosion in technological advances has provided physicians and patients more options in the diagnostic breast biopsy arena. prosperous collaborative relationships between nurses, physicians, and all health care workers and detailed patient education are essential to provide optimum patient care. Survival in health care today mandates that perioperative give suck tos and their colleagues move outside traditional environments to provide quality, cost-effective care to patients and their family members. The aim of this collaborative approach to breast biopsy is to provide patients with the mostly expedient, accurate, cost-effective diagnoses with the least amount of physical and psychological trauma. AORN J 69 (April 1999) 810-821

With technological advances, diagnostic breast biopsy transactions are moving out of the OR environment and into the breast imaging department. Thirty years ago, a diagnostic breast biopsy with frozen section and a possible mastectomy were performed forward patients under general anesthesia as individual procedure. Patients would awaken from anesthesia asking if their breast had been remov We have learned a great deal in the past 30 years. Early detection and intervention gives caregivers the greatest defense against breast cancer, nevertheless what happens when a patient perceive s a lump or a physician notices a lesion upon a mammogram? What do perioperative supply with nourishments contribute to this patient population?

FROM DETECTION TO DIAGNOSIS

Detecting a breast lesion may be accomplished with routine breast self-examination, a physician breast examination for palpable lesions, and mammographic screening for nonpalpable lesions. If an abnormality is identified, further diagnostic interventions are warranted. A mammogram is a bilateral breast image taken from a cranial caudal and medial lateral oblique view.(1) Additional information is obtained if there is an area of regard noted by the radiologist. Additional images of the breast allow the radiologist to determine whether the lesion warrants biopsy. Other breast imaging techniques include ultrasonography, magnetic resonance imaging (MRI), and scintimammography.

Further imaging workup. Additional mammographic views include magnification views, with or without a speckle compression; exaggerated cranial caudal views; turn views; and push-back views for patients with breast implants. The additional views provide the radiologist greater ability to diocese the area in question. The radiologist notes areas of density and microcalcifications and compares in every one's mouth mammograms to previous breast images for changes in breast composition. Criteria are used to help radiologists determine whether a lesion should be biopsied.

Ultrasonography is an imaging technique using healthy waves reflected by breast tissue.(2) It is used to evaluate whether a lesion is cystic or solid. If the lesion is solid, it is evaluated in word s of shape, definition, posterior shadowing, and vascularity. If there are a fate of penetrating vessels noted, the suspicion of breast cancer is increased.

Magnetic resonance imaging uses high-radio frequencies in a magnetic field to yield images of breast tissue based forward water content.(3) Dye is necessary to enhance the image when MRI is used for breast cancer detection. Researchers are still investigating the effectiveness of MRI for breast screening and biopsy. This technique can be used to veil dense breast tissue but remains expensive, confining, and difficult to interpret. Findings ne to be correlated with other breast imaging examinations.

Scintimammography involves injecting a radioactive contrast agent into the patient's arm vein.(4) The radionuclide arises into the breast vessels and emits gamma rays that are lay opened by a gamma camera. A brighter image is produc when a malignant lesion is involved because of increased vascularization of the malignancy. This technique can be used when ultrasound or MRI are not readily available, the lesion is greater than 1 cm or the breast tissue is dense

After further imaging studies have been performed, the radiologist decides whether a lesion requires to be biopsied and collaborates with the attending physician or surgeon Many factors are considered when determining which biopsy option to use.

BREAST BIOPSY OPTIONS

Breast biopsy options include fine needle aspiration, core biopsy, and explain surgical biopsy. The radiologist, surgeon and patient discuss biopsy options and make a collaborative decision.

Fine needle aspiration. Fine needle aspiration (FNA) is the removal of enclosed spaces from the breast using a 21-g to 25-g needle introduced into the lesion. This means may be performed by a surgeon or radiologist. The physician applies negative press with a syringe and transports cells and sends them to cytology for evaluation. be deriveds may show whether the lesion is malignant or benign; however, the rises will not provide adequate histological information because there is no tissue to examine beneath a microscope. One disadvantage of this technique is that an additional conduct is required if the pathology outcomes show malignancy. Adequate suspicious breast tissue is necessary to determine the correct surgical, radiological, and chemotherapeutic plan.