Undertake biopsy of breast tissue using imaging

1. apply standard precautions for infection prevention and control and other appropriate health and safety measures 2. prepare the equipment required for the procedure and check it is working correctly 3. examine relevant images prior to performing the procedure to confirm the location(s) of the region(s) of interest 4. review all additional relevant information and decide the most appropriate approach 5. review the individual’s clinical history for factors which might contra-indicate the procedure 6. ensure the environment is conducive to maintaining the privacy and dignity of the individual 7. check the identification details before commencing the procedure in accordance with local policies and procedures 8. communicate with the individual / key people to facilitate their understanding of and co-operation with the examination 9. establish the individual’s capacity to understand the procedure with the help of key people if necessary 10. obtain valid consent for the procedure in accordance with national and local guidelines  11. respect the individual’s privacy, dignity, beliefs and decisions  12. explain the procedure in a manner which encourages the individual to relax and co-operate with the requirements of the procedure 13. assess the individual’s emotional needs and respond appropriately 14. take appropriate images to confirm the correct position for needle placement and safety margins 15. take all appropriate precautions to ensure a clean/aseptic technique 16. ensure that local anaesthetic is given according to local protocols and loss of sensation is checked and, where required, the skin is incised 17. insert the correct needle for the procedure according to local procedures and protocols 18. check the positioning of the needle is correct by further imaging and make any necessary adjustments according to local procedures and protocols 19. take, check and site mark samples according to local procedures and protocols 20. ensure haemostasis of the wound 21. dress the biopsy site appropriately 22. label sample containers and complete pathology request forms 23. provide the individual with information relating to the procedure and aftercare where necessary 24. explain the process for obtaining results 25. document the procedure according to local protocols 26. issue reports of the specimen radiograph to the surgical team according to local protocols 27. recognise where help or advice is required and obtain this from appropriate sources

1. legal, organisational and policy requirements relevant to your role, the role of others in your organisation and the activities being carried out 2. the relevant national and local standards, guidelines, policies and procedures that are available and how and when they should be accessed 3. the importance of respecting individuals’ culture, privacy, dignity, wishes, beliefs and decisions  4. the limitations of your own knowledge and experience and the importance of operating within your scope of practice 5. the roles and responsibilities of other team members 6. the importance of obtaining valid consent in line with national and local guidelines 7. the purpose of the breast diagnostic and screening services 8. the quality assurance programmes in symptomatic, assessment and breast screening services 9. the mammographic manifestations of breast disease and normal variations as a result of age, hormonal state, surgery and radiotherapy 10. the anatomy, physiology and pathology of the breast, axilla, subcutaneous tissues and associated structures 11. the changes in images, physical appearance or feel of breast tissue as a result of age, surgery, hormonal state, medication or radiotherapy 12. the local protocols for biopsy procedures 13. the appearance of abnormal or suspicious areas on mammograms 14. local policies for aseptic technique 15. the contra-indications to the procedure 16. how to review an individual’s clinical history for factors which might contra-indicate the procedure  17. the underlying principles of stereotaxis 18. how to adapt communication styles, ask questions, and listen carefully in ways which are appropriate for the needs of the individual 19. methods of communicating difficult and complex information to individuals and key people 20. the importance of providing individuals and key people with opportunities to ask questions and increase their understanding 21. the information that should be given to individuals before, during and on completion of the examination 22. the biopsy equipment, its correct preparation, attachment and calibration 23. the safe use of local anaesthesia 24. the appearance of biopsy samples and indications for imaging specimens 25. the importance of accurate labelling of samples  26. the possible complications during and after biopsy of breast tissue and their management 27. the need to optimise the radiation dose received by the individual 28. the features of the relevant imaging equipment and the imaging process 29. how to keep full, accurate and clear records in line with organisational procedures