Breast Biopsy

A breast biopsy may be recommended when an examination or breast imaging identifies an area that cannot be fully understood through imaging alone. Needing a biopsy does not mean that you have breast cancer. A biopsy provides tissue that a pathologist can examine to determine what the abnormality is and whether additional care is needed.

What Is a Breast Biopsy?

A breast biopsy removes a small amount of tissue from an area of concern so it can be examined in a pathology laboratory. Imaging can help clinicians locate and characterize a breast abnormality, but tissue analysis provides the information needed to determine whether the finding is benign, cancerous or represents another breast condition.

There are several ways to perform a breast biopsy. The method recommended for you depends on factors such as where the abnormality is located, how it appears on imaging and which imaging method shows it most clearly. Most breast biopsies can be performed using a needle rather than surgery.

Core-Needle Breast Biopsy

Core-needle biopsy is often the preferred method when tissue sampling is needed. A hollow needle removes small cores of tissue that allow a pathologist to examine both the cells and the structure of the sampled tissue. These samples can usually provide the information needed to determine whether cancer is present and, when cancer is found, may provide tissue for additional laboratory testing that helps guide treatment planning.

When appropriate, the Margie Petersen Breast Center may be able to perform a biopsy on the same day as your breast evaluation. This can help reduce the time between identifying a concerning finding and obtaining the information needed to determine the next step.

How Is a Breast Biopsy Guided?

The imaging method used to guide a breast biopsy depends on how the abnormal area was identified and which type of imaging shows it most clearly. Image guidance allows the physician to accurately position the biopsy needle in the area that needs to be sampled.

Ultrasound-Guided Breast Biopsy

When an abnormality can be clearly seen with breast ultrasound, real-time ultrasound images can be used to guide the biopsy needle to the appropriate location. Ultrasound guidance allows the physician to see the abnormality and needle during the procedure without the use of X-rays.

Stereotactic Breast Biopsy

A stereotactic biopsy uses mammographic images to locate an abnormality and guide tissue sampling. This approach may be used for findings that are best seen on mammography, including certain areas of calcification or other changes that may not be visible with ultrasound.

MRI-Guided Breast Biopsy

MRI guidance may be used when an abnormality is visible on breast MRI but cannot be adequately identified with mammography or ultrasound. MRI images are used to locate the area and guide the biopsy needle so tissue can be collected from the finding that requires evaluation.

When Is a Surgical Breast Biopsy Needed?

Most breast abnormalities that require tissue sampling can be evaluated with a needle biopsy, so surgical biopsy is needed much less often. It may be considered when a needle biopsy cannot adequately sample an abnormality, when biopsy results do not sufficiently explain the imaging finding or when additional tissue is needed to establish a diagnosis.

During a surgical biopsy, part or all of the abnormal area is removed for examination by a pathologist. Your care team will explain why surgical biopsy is being recommended and how the procedure differs from a core-needle biopsy when it is appropriate for your situation.