When visiting the hospital, many women will feel uncomfortable when they hear about doing a gynecological examination, and if the doctor asks them to do a "biopsy", it will be even more uncomfortable!
A flurry of worries overwhelmed me.
"Is my illness serious?"
"Is this going to hurt?"
"Do I need anesthesia?"
In fact, biopsies are not as scary as you think. Zhimei chose the biopsy topic that everyone is most concerned about, and today we will explain it clearly.
Biopsy, short for biopsy.
The diseased tissue is first removed from the human body by means of incision, forceps, puncture, etc., and then the pathologist conducts a pathological examination, and finally the clinical diagnosis and treatment plan of the disease are obtained.
Biopsy can be divided into excision biopsy and excision biopsy, the former is to cut part of the lesion for diagnosis, such as cervical forceps, breast puncture and so on.
The latter is to remove all the lesions, and even cut some more surrounding normal tissues for diagnosis, which has the effect of diagnosis and treatment, such as tumors under the skin.
Don't underestimate it, it is called the "gold standard" of diagnosis, because even X-rays, ultrasound, CT, and MRI can only look at it roughly, and whether the lesion is a "good citizen" or an "evil person" depends on it.
It can be said that the abnormal tissue that grows on the body can be tested with it.
For example, patients with cervical cancer screening (TCT +HPV) who have problems, that is, suspected high-grade lesions or carcinogenesis of cervical cells, will be asked to have a colposcopy.
This allows doctors to biopsies suspicious areas of the cervix and, if necessary, to take samples of the vaginal wall and intranocle [1].
For example, when a mass is found in the breast by ultrasound, molybdenum and other examinations, especially when it shows that the BI-RADS grade 4 or level 3 has been upgraded after a period of follow-up grading, puncture sampling is also required [2] to determine whether it is a benign mass or malignant, and whether it is breast cancer.
So, biopsies are important, but don't ignore it anymore.
Before the women undergo a biopsy, one of the things they are worried about is, does this operation hurt? Can I anesthetize? Will there be a lot of blood?
Take another example of the cervix and mammary glands:
Cervical tissue is mainly connective tissue and a small amount of smooth muscle tissue, pain nerve distribution is small, a small amount of sampling will not cause obvious pain in women, even if there is occasional mild pain and spastic discomfort, can be tolerated, do not need anesthesia to play.
However, the sensitivity and tolerance of each person is different, there are a small number of people who are difficult to relax physically and mentally, will feel extremely uncomfortable, and the doctor will help the patient relax according to the situation, and do not worry too much.
Breast biopsy is generally performed by puncture, and commonly used methods include fine needles, thick needles, hollow core needles, and vacuum-assisted minimally invasive punctures [3].
Puncture from the skin to enter, layer by layer, directly to the lesion, before the operation will be local anesthesia in the skin, this time will be like a needle a little painful, wait until the anesthesia onset puncture will not feel much.
Puncture is performed with the assistance of the imaging device, reducing unnecessary damage, so there is no need to worry.
As for bleeding, as long as the cervix does not form a large lesion, the biopsy will not make it worse; breast puncture is only a small blood vessel damage caused by the puncture, with some bleeding.
The above two cases can basically stop on their own after a short period of compression.
Originally, I thought of coming to the hospital for examination, and when I got the results, I went directly to the doctor to see, which could save a lot of things, but I was told that I could wait until the results of the examination at least 3 days later.
Do I really have any big problems that doctors should study carefully?
In fact, this is not the case, because the pathological examination after biopsy is a big project.
After the specialist obtains the biopsy tissue, it is properly stored in the fixative solution and sent to the pathology department.
After the pathology department takes over the pathology section, it also undergoes a series of assembly line treatments, such as fixation, material extraction, dehydration, transparency, wax immersion, embedding, sectioning, dyeing, etc. [4].
It doesn't matter if you don't understand it, in simple terms, the above operations are to get standard pathological slides that can be observed.
After the corresponding pathologist gets the pathological slice, he observes it with a microscope, and each group ranges from ten minutes to tens of minutes, and when it encounters difficulties, it is necessary to verify the data and internal discussion before reaching a conclusion.
If the diagnosis is malignant, it will take two doctors to reach an agreement before a final report can be issued, which is twice as long.
In addition, the pathologist does not just diagnose the slice of a patient alone, but also follows the order of first-come, first-served, and the time is naturally long.
In most cases, the results are available in about 3 days, and if a special case is encountered, it may be delayed for a few days due to additional tests.
Don't get the report and don't read it? Master these common nouns to know if there is a problem with your body.
The report content of cervical biopsy can be roughly divided into 3 categories: inflammation, reactive changes, cervical intraepithelial neoplasia (precancerous lesions and cervical cancer). Women should pay the most attention to the third category.
When the results of the examination show LSIL (usually including CIN I and P16-negative CIN II), i.e. low-grade lesions, treatment is usually not required, but periodic review is required to observe the development of the disease;
When HSIL (usually including CIN III and P16-positive CIN II) is shown on examination, that is, high-grade lesions or carcinoma in situ, cervical cancer may develop, requiring prompt intervention, such as resection, and regular review [5].
The same is true of breast biopsy reports, and the word that women care about most is "cancer."
As long as you avoid this word, you can basically rest assured that you can rest assured that according to the specific nature of the breast mass, you can decide that it can be retained or surgically removed.
The process of biopsy must pass through some normal tissues, if the lesion is malignant, will the tumor fall to these places because of the doctor's operation?
In fact, this worry is not necessary.
Breast punctures are performed under the positioning of imaging equipment, it can be said that the doctor has targeted it, and all that is left to do is to hit the lesion directly.
The needle used by the doctor is also designed for protection and does not allow the tissue of the lesion to escape at will.
Potential metastasis may be reduced by another 10% during surgery shortly after puncture, or if surgery removes both the puncture point and the needle path [3].
The vagina is fully opened during cervical biopsy, providing sufficient space for manipulation, and the contact time of each sample is also very short, and the possibility of cancer tissue falling and metastasis is also very small.
postscript
Biopsy, in fact, is only a medical means, serving our health, and we don't have to think of it as too scary.
We must also believe in the doctor's decision, they will choose the necessary tests for us according to the type of disease, strictly according to the indications, only in this way can the disease be strangled in the cradle and escort women.
Reviewer
Gu Lin | Director of the Department of Breast Oncology II, Tianjin Cancer Hospital
Julie | Chief Physician of the Department of Gynecology, The Fourth Affiliated Hospital of Harbin Medical University
bibliography
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Wang Yongnan,Wang Ji. Evaluation, diagnosis and treatment of breast nodules[J].Chinese Journal of Breast Diseases (Electronic Edition), 2016,10(06):321-325.
Ouyang Tao. Puncture biopsy of breast lesions[J].Chinese Journal of Practical Surgery,2009,29(03):264-267.
HE Xiaomei. Analysis of the application value and accuracy of breast mass puncture in clinicopathological diagnosis[J].Electronic Journal of Cardiovascular Diseases in Integrative Traditional Chinese and Western Medicine,2019,7(36):5-6.
Xie Xing,Kong Beihua,Duan Tao. Obstetrics and Gynecology (Ninth Edition)[M].People's Medical Publishing House, 2018.
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