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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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No Bruising Post Tissue Needle Biopsy For A Lump Above The Cancerous Site. What Other Than Scar Tissue Can Cause Bleeding?

Hi I was diagnosed with breast cancer in 2009. It had spread to my lymph nodes and had them removed on the side of the cancer. I had chemo and radiotherapy but a lump was felt just above the site of the earlier cancer at a recent check up and was sent for an ultrasound where they took a tissue needle biopsy. I expected some bruising but haven t any. My concern is that cancerous lumps don t usually bleed and if it was scar tissue, which is the other option it probably would have bled??
Wed, 7 Nov 2012
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Oncologist, Radiation 's  Response
Hi Michele Jacobi
The first thing that has to be done once you find a lump in the region of the chest wall is to confirm what it is. In your case a biopsy has already been done and let us await its result. Your understanding that cancerous lumps dont bleed after biopsy is correct. But I think your presumption that if it was scar tissue it would have bled is not correct. Scar tissue also need not bleed. Needle biopsies does not usually cause any bleeding unless a blood vessel is ruptured during the procedure
Since how long have you noticed this lump. Is the size of the lump increasing ?
If the biopsy comes as positive for cancer then you will have to undergo a series of investigation to find out he the extent of the disease. ? Whether it is confined to the chest wall only or whether it has gone beyond the chest wall to other regions. Treatment decision will depend on the results of this
If the biopsy comes as negative for cancer then there are 2 options
1- If your physician thinks it is insignificant then you need to follow it up. Just keep a check on your lump to see whether it is increasing in size and also get it checked by your physician regularly
2- The second option (and my preference) is to do an open biopsy especially if the lump was detected recently and is increasing in size and also if the lump is firm to hard ( and not very soft). The reason is needle biopsy can be negative but this does not always mean there is no cancer especially if the tissue sample taken is not adequate. Also time factor is important. You may loose time keeping the lump under follow up to see whether it is increasing in size
Hope you are satisified with my reply. Anyway dont worry. Follow your doctors advice

Dr Edison
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No Bruising Post Tissue Needle Biopsy For A Lump Above The Cancerous Site. What Other Than Scar Tissue Can Cause Bleeding?

Hi Michele Jacobi The first thing that has to be done once you find a lump in the region of the chest wall is to confirm what it is. In your case a biopsy has already been done and let us await its result. Your understanding that cancerous lumps dont bleed after biopsy is correct. But I think your presumption that if it was scar tissue it would have bled is not correct. Scar tissue also need not bleed. Needle biopsies does not usually cause any bleeding unless a blood vessel is ruptured during the procedure Since how long have you noticed this lump. Is the size of the lump increasing ? If the biopsy comes as positive for cancer then you will have to undergo a series of investigation to find out he the extent of the disease. ? Whether it is confined to the chest wall only or whether it has gone beyond the chest wall to other regions. Treatment decision will depend on the results of this If the biopsy comes as negative for cancer then there are 2 options 1- If your physician thinks it is insignificant then you need to follow it up. Just keep a check on your lump to see whether it is increasing in size and also get it checked by your physician regularly 2- The second option (and my preference) is to do an open biopsy especially if the lump was detected recently and is increasing in size and also if the lump is firm to hard ( and not very soft). The reason is needle biopsy can be negative but this does not always mean there is no cancer especially if the tissue sample taken is not adequate. Also time factor is important. You may loose time keeping the lump under follow up to see whether it is increasing in size Hope you are satisified with my reply. Anyway dont worry. Follow your doctors advice Dr Edison