Breast Biopsy

Imaging studies, along with physical exams of the breast, can lead doctors to suspect that a person has breast cancer. However, the only way to know for sure is to take a sample of tissue from the suspicious area and examine it under a microscope. This is known as a biopsy and it is the only test that can tell if cancer is present. It will help us to know if surgery is required and if so, the type of surgery required.

The gold standard method for biopsy of a breast abnormality is a core needle biopsy performed under image-guidance. This procedure is performed under local anesthesia and is highly accurate for diagnosis. If a breast cancer is diagnosed, surgery for treatment of the cancer can be appropriately planned without having required a separate surgery for diagnosis alone.

Pathologist looking at specimens under microscopes

In certain instances, a core needle biopsy is not technically feasible, in which case a surgical biopsy may be recommended for diagnosis. This procedure is the most invasive of the biopsy techniques so is typically reserved when a core needle biopsy is not possible. During a surgical biopsy, your surgeon removes all or part of a breast lump. In general, a small lump will be completely removed (excisional biopsy). If the lump is large, only a sample will be taken (incisional biopsy). Even though this is considered surgery, this type of biopsy is generally performed on an outpatient basis.

Biopsy Procedures:

A biopsy is a procedure done to remove tissue from an area of concern in the body using the following imaging techniques:

  • An ultrasound- guided core needle biopsy is a less invasive procedure conducted using an ultrasound and a biopsy device.
  • Stereotactic biopsy. This technique is used to sample and evaluate areas of concern, such as clusters of microcalcifications that are seen on mammogram alone. During the procedure, a radiologist trained in doing this procedure removes a tissue sample via a core needle, using stereo mammographic images as a guide. Stereotactic biopsy procedures are minimally invasive and are performed using local anesthesia. The entire procedure takes approximately one hour.
  • MRI-guided biopsy. An MRI-guided biopsy is a vacuum-assisted biopsy for an abnormality seen only on MRI and uses the MRI to locate the area of abnormality.
  • Surgical biopsy is done in the hospital on an outpatient basis with a light anesthetic and local anesthesia. It is often done if the results of a needle biopsy are unclear or if it is not possible to do a needle biopsy.

The tissue specimen is examined by a pathologist to see whether or not cancer cells are present. If cancer is present, the pathologist can then look at the cancer’s characteristics. The biopsy will result in a report that lays out all of the pathologist’s findings. Your pathology results will be available to your provider in a few days. He/she will call you regarding the results when they are accessible.

Things to Know for Your Biopsy

You should expect some mild bruising, swelling and soreness in the breast after your procedure. This will usually resolve within a week. Most patients do well with applying ice, taking over-the-counter anti-inflammatory medication such as Extra Strength Tylenol, and wearing a supportive bra for symptomatic relief of the discomfort. In some cases, a hematoma may form where the biopsy was performed. A hematoma is a collection of blood outside of a blood vessel due to trauma, surgery, or disease. A hematoma is a benign condition and usually resolves itself over time. Applying heat to the site usually helps allow the blood to diffuse into the tissue.

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Questions?

The Breast Health Clinic can be reached at (310) 582-7209. If you have questions regarding a new symptom or want to make an appointment for evaluation please call and a staff member will assist with navigating you in the right direction.

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