What is a breast biopsy?
A breast biopsy is a procedure to diagnose or rule out breast conditions, including breast cancer. It involves removing a small tissue sample from the breast. Your doctor will send the tissue sample to a pathologist who will determine whether breast disease is present.
Common breast biopsy procedures include fine and core needle biopsy of the breast. Doctors also perform vacuum-assisted, incisional, and excisional breast biopsies. This is how they work:
Fine needle aspiration biopsy uses a thin needle to withdraw a sample of cells. Your doctor may perform the procedure with X-ray guidance to visualize the breast tissue and placement of the needle. This is a stereotactic breast biopsy. It works like a mammogram.
Core needle breast biopsy uses a larger needle to withdraw a small cylinder—or core—of tissue.
Vacuum-assisted biopsy uses a probe to withdraw multiple core biopsies through one small incision.
Incisional biopsy is like traditional surgery that cuts through the skin to remove a sample of breast tissue.
Excisional biopsy is the most invasive biopsy that involves removing an entire area of breast tissue.
Having a breast biopsy and waiting for the results can be stressful. For some people, talking with the doctor about the procedure and the possible results help ease some of the anxiety you may feel. Keep in mind that a breast biopsy can help diagnose breast cancer at an early stage when the chances of survival are highest.
Why is a breast biopsy performed?
Your doctor may recommend a breast biopsy if there is a lump in your breast or you had an abnormal screening mammogram. In some cases, a diagnostic mammogram, breast ultrasound, or breast MRI can rule out breast cancer. Other times, a breast biopsy is necessary to see if breast cancer or another breast condition is present.
Who performs a breast biopsy?
General surgeons and radiologists commonly perform breast biopsies. General surgeons specialize in the surgical treatment of many diseases, disorders and conditions. Radiologists or interventional radiologists use imaging technology, such as X-rays and MRI, to diagnose and treat many diseases.
How is a breast biopsy performed?
Your breast biopsy will likely be performed in a hospital or dedicated breast center. Doctors usually use X-rays, ultrasound or MRI during a breast biopsy to precisely locate the area to sample. The length of procedure depends on the type of biopsy, but generally involves these steps:
You will dress in a patient gown and lie on a procedure table. Depending on the type of biopsy and imaging guidance, you may be on your back or your stomach. If you are on your stomach, the table will have a hole for your breast. If you are on your back, your team may need to prop your shoulders or sides to make the biopsy site more accessible.
Your doctor will inject a local anesthetic into your breast to numb the area. For surgical biopsies (incisional and excisional), you may also receive sedation to keep you relaxed and drowsy during the biopsy.
Your team will locate the biopsy area using imaging guidance. This is a called a stereotactic breast biopsy. For surgical biopsies, your doctor may also use wire localization. He or she will use a needle to place a small wire into the area. The wire helps guide the surgery. It also lets the doctor X-ray the sample after removal to verify the correct tissue was removed.
Your doctor will remove a tissue sample. For needle biopsies, your doctor may insert the needle several times to get multiple samples. The device may make loud clicking sounds when the doctor triggers the needle. For surgical biopsies, the doctor will make a small skin incision to remove the sample.
Your doctor may place a small metal clip inside the breast at the biopsy site. The clip remains in place to identify the biopsy site for future imaging exams or surgeries.
Your doctor will likely use sutures, or stitches, to close a surgical biopsy wound. Needle biopsies usually do not require sutures.
Your team will clean and bandage your breast.
Will I feel pain?
Your comfort and relaxation is very important to both you and your care team. You should not feel pain during your procedure with local anesthetic. You may feel pressure or a pushing or pulling sensation during needle biopsies. Take a few long, deep breaths to help yourself relax. For surgical biopsies, you will have sufficient sedative medications to stay comfortable. Tell your doctor or a member of your healthcare team if you are uncomfortable.
What are the risks and potential complications of a breast biopsy?
Complications after breast biopsy are not common, but any medical procedure involves risk and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery. Risks and potential complications of a breast biopsy include:
Adverse reaction or problems related to sedation or local anesthesia such as an allergic reaction
Bruising and swelling of the breast
Changes in breast appearance or shape, which is more likely with surgical biopsies
Scarring, which is more likely with surgical biopsies
Reducing your risk of complications
You can reduce the risk of certain complications by:
Following activity restrictions during recovery
Informing your doctor or radiologist if you are nursing or if there is any possibility of pregnancy
Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
Taking your medications exactly as directed
- Telling your care team if you have allergies
How do I prepare for a breast biopsy?
The steps you take before your procedure can improve your comfort and outcome. You can prepare for a breast biopsy by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
Questions to ask your doctor
Preparing for a breast biopsy can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before the biopsy and between appointments.
It is also a good idea to bring a list of questions to your appointment. Questions can include:
Why are you recommending this type of breast biopsy? If your doctor recommends a surgical biopsy, ask if a needle biopsy is an alternative.
What area will you biopsy and can I see the results of my imaging exams?
How long will the procedure take? When can I go home?
How often do you encounter complications from the procedure?
What kind of restrictions will I have after the procedure? When can I expect to return to work and other activities?
What kind of assistance will I need at home? Will I need a ride home?
What medication plan should I follow before and after the procedure?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
When and how will I receive the results of my biopsy?
What other tests or treatments might I need?
What can I expect after my breast biopsy?
Knowing what to expect after a breast biopsy can help you get back to your everyday life as soon as possible.
How will I feel after the breast biopsy?
You may have soreness and discomfort after the breast biopsy. If you had sedation, you might feel a little drowsy. You may receive medication to control your pain. Tell a member of your care team if your pain is not well controlled by your medication because it can be a sign of a complication.
When can I go home?
You should be able to go home the same day after most breast biopsies. If you had sedation, you may still be drowsy and will need a ride home from your procedure. You will not be able to drive for about 24 hours, and someone should stay with you during this time.
For most breast biopsies, over-the-counter pain medicine and ice packs can help ease pain and reduce swelling. Call your doctor if your pain medicine is not controlling your pain or it changes in any way. It could be a sign of a complication.
Recovery time depends on the type of breast biopsy. Biopsies involving an incision and stitches have a longer recovery than needle and vacuum-assisted biopsies. For these noninvasive biopsies, you should be able to get back to your normal activities within 24 hours. Recovery can take a couple of weeks for incisional and excisional breast biopsies.
When should I call my doctor?
It’s important to keep your follow-up appointments after a breast biopsy. Contact your doctor if you have any concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Pain that is not controlled by your pain medication
It can take a few days to get the pathology results of your breast biopsy. These results will guide your next steps. If the results are benign (not cancer), no further treatment may be necessary. In other cases, your doctor may recommend additional surgeries or treatments. If the biopsy shows you have breast cancer, your breast surgeon will work with you to arrange the extra medical care you need, including an oncologist. Coordinated cancer care offers the highest chance of successful breast cancer treatment.