Susan A. Seedman MD, FACS, PC Aiding in the Fight Against Breast Cancer Breast Specialty Care
 
 
  Office Based Surgical Procedures

ASPIRATION - removal of fluid from a mass such as a cyst, seroma, hematoma or abscess using a needle and syringe. Local anesthetic and ultrasound guidance are sometimes used.

BIOPSY - removal of tissue from the body to study it under a microscope and make a diagnosis

Biopsies are divided into Incisional (part of the tissue is removed) and Excisional (all the tissue in question is removed)

Incisional Biopsy

Percutaneous- tissue is removed through a puncture in the skin.

Fine needle aspiration (FNA) - a thin needle is used to remove cells from the tissue.

Core needle biopsy - a large bore needle is used to remove the tissue. Usually, a small opening (~1/5 of an inch) is made in the skin with a scalpel.

Open biopsy - an opening (incision) an inch or larger in size is made in the skin. A piece of the area is removed and sutures (stitches) are usually required to close.

Excisional Biopsy

Percutaneous - tissue in question is removed completely using a vacuum assisted device placed through a small opening in the skin.

Open biopsy - all of tissue in question is removed through an incision which is then closed with sutures.

Localization-Dye/Needle localization biopsy (breast wire or dye localization) - abnormal appearing tissue, including microcalcifications, that is seen on mammogram or ultrasound is localized using a thin metal wire or dye prior to performing an open biopsy to ensure that the tissue in question is removed. The localization is done by the radiologist and the biopsy is done by the surgeon in the operating room..

INCISION and DRAINAGE - a small opening is made into the skin to puncture into an area that has a fluid collection such as an abscess. Ultrasound is usually used for guidance. After the fluid is drained the wound is left open to heal gradually so that no infected fluid will be trapped. Occasionally, a plastic drainage tube is left and the skin is closed. Antibiotics may also be prescribed.

MAMMOSITE PLACEMENT - after removal of a breast cancer (lumpectomy/wide axcision/ tylectomy), a catheter (plastic, hollow tube) is placed into the cavity that is left in order to deliver high-dose radiation to that local area. The catheter is placed under local anesthetic in the office using ultrasound guidance. Administration of the radioactive material is done subsequently by the radiation oncologist.

VENOUS PORT REMOVAL (Porta-cath and others) - removal of a port that has been used for administration of chemotherapy or blood drawing. A skin incision is made using local anesthesia and the port is removed with its tubing intact. Sutures are used to close the skin.