Breast Biopsy Overview
A breast biopsy, which involves removing a sample of breast tissue for testing in a lab, will generally be ordered after other diagnostic tests have revealed a suspicious lump or mass in your breast. A biopsy is the only way to tell for sure if the lump or mass is benign or cancer.
Before the Procedure
- If you are having general anesthesia, you may be asked not eat or drink for 8-12 hours before the test.
- The Wellstar physician will ask questions about your medical history and perform a manual breast exam.
- Do not wear lotion, perfume, powder or deodorant under your arms or on your breasts.
- Your Wellstar physician may ask you to discontinue blood-thinning medications or aspirin.
- If your biopsy will be done using magnetic resonance imaging (MRI), tell your physician if you have a pacemaker or if you're pregnant or may be pregnant. MRI often isn't advised under these circumstances.
- Be sure to wear a bra to your appointment. You may need a cold pack on the biopsy site after the procedure, and the bra will hold it in place while providing support for your breast.
- Be sure to follow any other instructions given to you in advance of the procedure.
During the Procedure
During a biopsy your Wellstar physician will remove cells from the mass or lump in your breast for the Wellstar pathologists to view under a microscope. Biopsies can be done with a needle or surgery. The type of biopsy you have will depend on the size, location and other factors of the area to be tested. Talk with your Wellstar physician about the pros and cons of each type of biopsy.
- Fine-needle aspiration biopsy is used most often to evaluate a lump that can be felt during a manual breast exam. For the procedure, which can be done in a doctor’s office, you lie on your back on a table. Your physician uses a very thin needle to withdraw (aspirate) a small amount of fluid or tissue from the suspicious area. If the fluid is clear, the lump is most likely a benign cyst. Bloody or cloudy fluid usually means a benign cyst or, very rarely, cancer. If the lump is solid, small pieces of tissue are drawn out. A pathologist will examine the tissue or fluid using a microscope to find out if it is cancer.
- Core needle biopsy may be used to assess a lump that's visible on a mammogram or ultrasound or that your physician can feel during a manual breast exam. In your physician’s office, you will be given a local anesthesia to numb your breast. Your physician will use a thin, hollow needle, not quite as thin as the one used in fine-needle aspiration, to remove tissue samples from the mass. Several samples, each about the size of a grain of rice, are collected and analyzed in a pathology lab. Imaging with mammography, ultrasound or MRI is often used to guide the needle in a core needle biopsy.
- Stereotactic biopsy uses breast mammogram's to pin point the suspicious areas in the breast. For this procedure, which can take 30 minutes to an hour, you lie facedown on a padded biopsy table with one of your breasts positioned in a hole in the table. The table is raised, and the Wellstar radiologist performing the biopsy sits under the table. Your breast is compressed between two plates while mammogram's are taken to show the radiologist the exact location of the biopsy area. A small incision is made in your breast. The radiologist inserts a needle or a vacuum-powered probe and removes several samples of tissue. The tissue sample is sent to a pathologist for analysis.
- Ultrasound-guided core needle biopsy uses high-frequency sound waves to produce precise images of areas of your body. For this type biopsy, you lie on your back on an ultrasound table and raise the arm on the same side as the breast to be biopsied. This stretches your soft tissues and ensures a better quality image. The radiologist locates the mass using ultrasound, makes a tiny incision to insert the needle and takes several core samples of tissue to send to a pathologist.
- MRI-guided core needle biopsy uses multiple cross-sectional images of your breast and combines them, using a computer, to generate 3-D pictures. For this procedure you lie facedown on a padded table, with a hollow depression for your breasts. The MRI provides images to help determine the exact location for the biopsy. A small incision is made to allow the core needle to be inserted. Several samples of tissue are taken and sent to a pathologist.
During a surgical biopsy your Wellstar physician may remove a portion or all of your breast mass. A surgical biopsy is generally performed in an operating room, with sedation and a local anesthetic. If the breast mass is situated where it can't be felt, your radiologist may use a technique called wire localization to map the route to the mass for the surgeon. During this procedure, the tip of a thin wire is positioned using mammographic guidance within the breast mass right before surgery. Sometimes the surgeon will have your tissue X-rayed before it goes to the pathologist. The X-ray may show that the edges (margins) of the sample have cancer cells, which means some cancer may still be in the breast and more tissue must be removed. If the X-ray shows the margins are clear, it's more likely that all the cancer has been removed. A tiny stainless steel marker or clip will usually placed in your breast at the biopsy site so that your physician can easily find the biopsy area. This makes future monitoring or follow-up procedures easier.
After the Procedure
- With all types of biopsy you can plan to go home the day of the procedure.
- You will have bandages over the site and perhaps an ice pack.
- If you have a surgical biopsy, your physician may prescribe pain medication. You will likely have stitches, and will need to care for them as your doctor recommends.
- Take it easy the first day, but you should be able to resume normal activities the next day.
- Bruising around the biopsy site is common with all types of biopsy. To relieve swelling and discomfort, if you have it, take non-aspirin pain relievers, such as Tylenol®.
- Following the analysis by the Wellstar lab pathologists, your physician will talk with you about the results of your biopsy.