Reviewed by: Emily F. Conant, MD
Updated October 1, 2010
When a test reveals a possible abnormality in your breast, your doctor may want to do a biopsy to make sure that the abnormality is not cancer. A biopsy involves taking a small amount of tissue from your breast and looking at it under a microscope.
Many women who get biopsies do not have cancer. If the pathologist finds cancer, the tissue sample will tell your doctor what treatment is needed or whether more tissue needs to be removed.
There are several different types of biopsies. The type you need depends on the size of the abnormal area and what your doctor can see on your mammogram, ultrasound or other study. Types of biopsies include:
- Fine-needle aspiration
- Core biopsy, also called vacuum assisted biopsy
- Stereotactic core biopsy
- Surgical biopsy, either incisional biopsy or excisional biopsy
Fine-needle aspiration. Your doctor will use a hollow, narrow needle to draw cells from the abnormal area. Fine-needle aspiration (FNA) sometimes can be done in your doctor’s office and usually does not leave a scar. You will receive a local anesthetic to numb your breast, and you will lie down for the procedure. If a definite lump cannot be felt, your doctor may use imaging machines like ultrasound to look at the area of concern.
Core biopsy. During a core biopsy (often called a vacuum assisted biopsy), a larger, hollow needle will be used to remove several samples of tissue from your breast. Your doctor may need to use imaging equipment to help find the area of concern if a definite lump cannot be felt.
Sometimes, the doctor may do the core biopsy on a special table or mammography machine; this is called a stereotactic core biopsy. Usually, you will lay face down with your breast hanging into a hole in a special table. A small mammography machine under the table takes images that help guide the doctor to the area to be biopsied.
Sterotactic or vacuum assisted biopsies can also be done with ultrasound or MRI. You will be given a local anesthetic, and the doctor will normally place a tiny clip into your breast after the biopsy to mark the site where the samples were taken. This helps the doctor find the area in case further biopsies or surgery are needed. Most women do not get a scar from these types of procedures.
Surgical biopsy. If your doctor needs more information about the abnormality than a needle or core biopsy can provide, he or she will do a surgical biopsy. A surgical biopsy may be called either an incisional biopsy or excisional biopsy, depending on how much breast tissue needs to be taken to get a good sample of the suspicious area. With these biopsies, you normally get local anesthesia, not general anesthesia. Because the surgeon uses a scalpel to cut into your breast to remove the abnormal tissue, you will get stitches. The procedure causes a scar, and you may need a couple of weeks to heal.