During breast biopsy, a small amount of tissue, cells or fluid is retrieved from a suspicious breast mass for microscopic examination.
Why is breast biopsy done?
A breast biopsy is a small procedure that allows your physician to retrieve a small sample of suspicious tissue for further testing. The typically simple diagnostic procedure is done to determine whether or not breast cancer is present.
When a suspicious area appears on breast imaging tests, such as mammography, MRI or ultrasound, your doctor may perform a breast biopsy to test for breast cancer. The procedure may also be done if a lump or area of thickening is discovered on the breast and if changes are noted in the nipple or there is bloody nipple discharge.
Even though your doctor has recommended a breast biopsy, it does not mean you have breast cancer. Approximately 80 percent of breast biopsies are negative for breast cancer, in these cases; breast biopsy provides peace of mind and reassurance that you are cancer-free.
How is breast biopsy done?
There are various techniques used to perform breast biopsy and your surgeon will recommend the one that is best suited to your specific situation. This may be determined by the size and appearance of the suspicious area or by its location on the breast.
Types of breast biopsy techniques include:
- Fine-needle aspiration – the least invasive of the techniques, aspiration is used on lumps that can be easily accessed and are thought to be fluid-filled. Using a needle attached to a syringe, a sample of fluid or cells is withdrawn from the lump. If the lump is a fluid-filled cyst, it collapses during the aspiration and may or may not return. If it redevelops, or the mass is solid, further investigation including possible surgical biopsy may be warranted.
- Core needle biopsy – after numbing the breast, a hollow needle is inserted and rice-sized samples of tissue are removed from the abnormal breast mass. Imaging studies, such as MRI or ultrasound, may be used to locate lumps that are difficult to pinpoint.
- Vacuum-assisted biopsy – for this diagnostic test mammography or ultrasound is used to guide a special instrument that has been inserted through a very small incision in the breast. The special probe removes a sample of breast tissue, which is gently suctioned through the probe into a container. The probe can be rotated a number of times allowing samples to be collected from multiple locations within the mass through a single incision.
- Surgical biopsy – your surgeon may perform an incisional biopsy if a diagnosis can’t be made from needle biopsy or if the abnormal area is very large. During the procedure, which takes place in a hospital setting, a local anesthetic is used to numb the breast and an IV sedative is administered to cause drowsiness. A section of the mass is removed and tested for malignancy. Excisional biopsy is a more extensive procedure that involves removing the entire lump or suspicious area from the breast. The mass is sent to the lab for testing and the margins of the tumor are evaluated to ensure they are cancer-free. If cancer is detected along the edges of the specimen, more surgery is needed. Prior to both types of surgical biopsy, hard-to-locate breast masses may be identified by mammography or ultrasound and a thin wire inserted to mark the location of the suspicious tissue. This technique is known as wire localization.
Recovery from breast biopsy
Following breast biopsy, patients go home the same day. A bandage is applied to the biopsy area and ice packs and over-the-counter pain medications such as ibuprofen or Tylenol may be used to reduce pain and swelling. Surgical biopsy patients will have sutures covered with a sterile dressing. The sutures should be kept clean and dry and remain in place until removed at a follow-up appointment.