Axillary dissection
This operation refers to removing most of the lymph nodes in the armpit (axilla). It is often performed in patients who have confirmed malignant lymph nodes.
Biopsy
Removing a sample of body tissue is a biopsy. There are various types depending on how much tissue is taken e.g. fine needle biopsy or aspirate (FNA), core biopsy, vacuum assisted breast biopsy and surgical (open) biopsy.
Breast density
This refers to how white your breast tissue appears on a mammogram and is a reflection on how much fibroglandular breast tissue there is relative to fatty tissue. It is not what the breast tissue feels like.
Core biopsy
A thicker hollow needle device is quickly fired through a solid structure, and a slither of tissue is obtained. Often a few passes are made, and the fragments are sent for histological analysis. Usually, ultrasound is used to accurately target the lesion, and local anaesthetic is always used to numb the skin and tissues.
Cytology
A pathologist analyses cells smeared on a slide under the microscope (usually obtained from a fine needle biopsy) and determines whether there are any unusual or cancerous cells.
Fine needle biopsy or aspirate
A very thin hollow needle is used to core out or suck out some cells. The sample is sent for cytological analysis. Often ultrasound is used to accurately target the lesion.
Histology / Histopathology
A pathologist examines a tissue specimen. This is cut into extremely thin tissue slices, then placed onto a slide and analysed under the microscope. Tissue is obtained from a core or surgical biopsy and depending on the size and complexity of the specimen may take a few days to process. The pathologist determines the nature of the tissue and whether there are any unusual cells or malignancy present.
Lymphoedema
Swelling of a limb or the breast due to poor lymphatic drainage. It can occur after lymph node surgery and/or radiotherapy. The risk of lymphoedema is variable and treatment is available to deal with this condition.
Mastectomy
This operation refers to removing the whole breast. Frequently patients will be offered a reconstruction at the same time, and in these cases most of the breast skin is preserved as a skin envelope and a plastic surgeon will fill the space with your own tissue (autologous reconstruction) or with an implant (alloplastic reconstruction).
Molecular profiling
Traditional analysis of cancers is performed by a pathologist looking at cells under a microscope and identifying adverse features which predict the risk of the tumour. Molecular profiling is another way of analysing a cancer, and looks at the DNA within the tumour cells to help predict how risky the disease is, and guide decisions regarding further treatments like chemotherapy and radiotherapy.
Oncoplastic breast conserving surgery
This term refers to the removal of cancerous tissue using plastic surgical techniques to maximise cosmetic outcomes. This can be advantageous in many situations, but most notably may avoid the need for a mastectomy (with or without reconstruction) and associated morbidity and longer recovery associated with mastectomy.
Pathology
This laboratory service analyses blood, body fluid and tissue samples. Blood analysis includes haematology and biochemistry. Tissue analysis includes cytology, histopathology and microbiology.
Pre-operative localisation
Many breast lesions are discovered on imaging and marked with a tiny harmless clip. In order to surgically remove these lesions with precision, a radiologist will insert a magnetic seed or a hookwire under image guidance and local anaesthetic before a planned operation under general anaesthesia. At Cabrini we use magnetic seed technology (Pintuition). An audible sound is made when a probe is placed close to the seed deployed into the target lesion.
Radioactive colloid
A protein labelled with a low dose of radioactive tracer. It is used to identify sentinel lymph nodes draining an area affected with cancer. An audible sound is made when a gamma probe detects radioactive tracer in the draining sentinel lymph node(s).
Sentinel lymph node biopsy
Surgical removal of a select few lymph nodes filtering lymphatic fluid from a particular area of the body. In the context of breast cancer, the sentinel lymph node(s) is the node(s) draining the cancer in the armpit (axilla) and the best node to check to see if cancer has spread to the nodes or not.
Surgical (open) biopsy
Under anaesthesia, a skin incision is made to take out part (incisional biopsy) or all (excisional biopsy) of the lesion in question. The specimen is sent for histological analysis.
Targeted axillary dissection
This operation refers to removing just some of the lymph nodes in the armpit (axilla). It is typically performed in patients who have confirmed malignant lymph node(s) and have gone on to have drug treatment before their breast cancer surgery. The aim is reduce the risk of surgical harm to the patient with less lymphoedema and quicker recovery, without compromising prognosis or recurrence. Cancer cells are often killed by the drug treatment and as such a malignant node may be found to be free of cancer when removed.
Wide excision cancer
Surgical removal of a cancer (typically in the breast) aiming to achieve clear margins (healthy normal tissue around the cancer). Also known as clear local excision, partial mastectomy and breast conserving surgery.
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