Puncture is an invasive diagnostic method during which a tissue or organ is punctured to take material for examination. Most often they resort to his help when examining the female breast. This is an early diagnosis of cancer, which ranks first among all cancer pathologies in women. Modern technology helps to perform this procedure with visualization. Puncture of the mammary gland under the control of ultrasound provides high accuracy and informativeness of the examination, eliminates excessive trauma.
Indications for the procedure
This diagnostic method, as a rule, is carried out simultaneously with mammography. Puncture analysis is recommended to detect nodules, seals and other neoplasms in the mammary gland. They also resort to his help if during the examination of a woman there is a change in the color and structure of the skin in the chest area, discharge from the nipples. Such symptoms may indicate oncopathology. The main task of breast puncture under ultrasound is the determination of the properties of cellular tissue elements. They can be benign or malignant.
Thus, the main indications for the appointment of a puncture study are the following violations:
- identification of compaction in the chest during palpation;
- lack of an unambiguous diagnosis after ultrasound;
- changes in the nipple area (redness of the skin, sores, peeling, discharge or retraction);
- suspected nodal mastopathy, fibroadenoma, or cyst.
Preparatory stage
Breast puncture under the control of ultrasound does not require specific preparation. It is important to choose the period when the breast is least affected by estrogen, since the tissue is less dense. The optimal period is from 7 to 14 days of the female cycle, if it lasts 28 days. If urgent diagnosis is necessary, the procedure is carried out at any time.
Three days before the date of the study, it is recommended to abandon the use of alcohol and drugs that affect blood coagulation. We are talking about "Aspirin" and a number of non-steroidal anti-inflammatory drugs. Reduced coagulability can cause bleeding and hematoma formation. On the eve of the study, you need to take a shower, but without using cosmetics.
Varieties of research
According to its purpose, the puncture of the mammary glands with ultrasound can be diagnostic or therapeutic.
According to the execution technology, the following procedure options are distinguished:
- Fine needle aspiration. This method is resorted to for small tumors located close to the skin. Seal zones are first marked with a marker and then punctured with a thin needle syringe. The fluid from the neoplasm is then sent for histological examination to the laboratory. The procedure is not accompanied by pain and does not require specific anesthesia.
- Thick needle aspiration. The procedure is performed using an automatic gun. It consists of a tube with a microknife at the end. The device with high precision cuts off the required number of tissues. The study is performed with local anesthesia.
The choice of a specific diagnostic method is determined individually.
Execution order
The puncture study is performed on an outpatient basis. The patient lies on the couch, after which the doctor performs anesthesia.
Fine needle puncture is carried out using a syringe. After puncture with a syringe, tissue material is sucked off, blown onto a glass slide. Then he is sent to the laboratory for histological examination. The whole procedure is carried out under the control of an ultrasound apparatus, due to which it is possible to get into an atypical neoplasm as accurately as possible.
When performing a large-needle puncture of the breast with ultrasound, biopsy needles with a wide clearance are used. They allow you to pick up a larger amount of material. A gun is connected to the needle. It creates negative pressure. Therefore, the required amount of material is sucked into the needle. Then it is placed in a test tube and sent for research to the laboratory.
After the puncture, the doctor closes the wound on the skin with an aseptic dressing. In order to avoid the appearance of hematomas for some time, an ice pack is applied to the site of the lesion.
Contraindications to the procedure
Any medical procedure, including an invasive one, has certain contraindications. Breast puncture under ultrasound control is no exception. Refuse or future transfer of the examination is necessary in the following cases:
- the presence of an infectious disease;
- period of pregnancy and lactation;
- recent breast surgery;
- heat.
About all contraindications in each case should tell the doctor in detail during the preliminary consultation.
Deciphering the results
Healthy breast tissue contains cells and fibers of the connecting elements, fatty lobules and epithelium. In this case, adipose tissue necessarily prevails on the connective, and atypical cells are absent.
In the case of a benign process, the puncture results will be slightly different. In this case, a large amount of connective tissue and epithelium with pronounced degenerative changes is observed in the biopsy sample.
With a puncture of a breast cyst under the control of an ultrasound, the nature of the content is also evaluated. Normally, the shade of the tissues of the biological material should be pink. A white or even greenish liquid is typical for a cyst. The presence of red blood cells in a puncture is not a sign of a malignant process. They can get into biological material, for example, when a vessel is damaged.
If atypical cells or elements with signs of malignancy are detected in the sample, the tissues are additionally examined for the presence of estrogen and progesterone receptors. This is an important stage of diagnosis, according to the results of which therapy will subsequently be prescribed.
Punctate analysis is usually performed within 3-4 days. If necessary, an urgent study is carried out, and it takes several minutes.
Possible complications
Significant complications after a mammary puncture under ultrasound control occur only in every second woman out of 1000. They include hematomas and the inflammatory process. In rare cases, bleeding from a puncture is observed. About 5% of women complain of dizziness or fainting attacks.
Relatively mild consequences of the procedure develop in 30-50% of cases:
- painful discomfort;
- bruising on the skin;
- emotional stress.
With severe pain, the use of pain medications is permissible. If discomfort persists for two weeks, it is recommended to seek medical help. Unwanted allergic reactions can also be easily avoided by warning a doctor about the intolerance of certain medications.
Reviews
Breast puncture under the control of ultrasound is perceived by most women ambiguously. They believe that such an examination always portends cancer. However, after the procedure, the opinion changes, because the result does not always indicate oncopathology. Therefore, reviews after the procedure are usually positive. There is no particular pain discomfort or complications. On the other hand, fear disappears and understanding of the need for such a diagnosis comes.
Today, a puncture can be done both in a state medical institution and in a private clinic or dispensary. Perform it only as prescribed by the doctor (surgeon, oncologist or mammologist). The cost of the study varies depending on the region of residence. For example, in the ECB, a breast puncture under ultrasound control will cost a thousand rubles. In Moscow, from 2 to 3.5 thousand rubles will have to be paid for this procedure. It is worth noting that in the presence of a compulsory medical insurance policy and a referral from a doctor, the examination is free of charge, but subject to appeal to a state clinic.