Biopsy

Updated 
August 31, 2015

A biopsyinfo-icon involves taking a small amount of tissueinfo-icon from your breast. This tissue is then analyzed by a pathologistinfo-icon, a doctor who specializes in diagnosing disease. The pathologist looks at the sample of your tissue under a microscope to see if it has any cancer cells.

Your pathologist reviews all the tissue samples from your biopsy, makes a diagnosisinfo-icon and then creates your pathology reportinfo-icon. After the final diagnosis, usually within a few days, the report will be available to the doctor who took your biopsy. It is that doctor who often reviews the results with you.

Getting a biopsy doesn’t mean you will be diagnosed with breast cancer. Most women who undergo a biopsy do not have cancer. Your doctors may be able to tell you how concerned they are about finding cancer before the biopsy. 

Types of Breast Biopsy

There are several different types of biopsies. The type you have depends on a number of factors, including the size of the abnormalinfo-icon area, what your doctor can see on your mammogram, ultrasound  or other imaginginfo-icon test, and your personal preferences.

Minimally Invasive Biopsy

In this type of biopsyinfo-icon, a provider uses a needle to take one or more tissueinfo-icon samples from your breast.

Sometimes this procedure can be done in your doctor’s office. A minimally invasive biopsy doesn’t require surgeryinfo-icon or general anesthesiainfo-icon. Local anesthesiainfo-icon may be used to numb the affected breast.

During a minimally invasive biopsy, you’ll lie down and the doctor will find the abnormalinfo-icon area by feeling for a lump. If a lump cannot be felt, your doctor may use imaginginfo-icon machines like an ultrasound, mammograminfo-icon or MRIinfo-icon to find the area. Many times the doctor will take multiple biopsies from the same area.

Fine-Needle Aspirationinfo-icon

The least invasive kind of needle biopsyinfo-icon is called a fine-needle aspiration, or FNA. It involves a narrow needle that is inserted into the area where the abnormal finding was seen. Your doctors may be very likely to recommend this option if they suspect the change in your breast is not a tumorinfo-icon but a liquid-filled cyst. Fine-needle aspiration usually causes cysts to collapse once the liquid is removed.

Doctors also may use an FNA to study enlarged lymphinfo-icon nodes.

Core Needle Biopsyinfo-icon

Core needle biopsy or CNB, often called vacuum-assisted biopsy, is similar to fine-needle aspiration. CNB uses a larger needle and may involve taking more or larger tissue samples.

CNB can be done on a lump that can be felt, with guidance from an ultrasound, mammographyinfo-icon machine or MRI machine. When the biopsy is performed using a mammography machine, it is called a stereotactic core biopsyinfo-icon. With a stereotactic core biopsy, you usually lie 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. 

After a CNB, the doctor will often place a tiny clip into your breast to mark the site where the tissue samples were taken. This helps the doctor find the area in case further biopsies or surgery is needed. Most women do not get a scar from these types of procedures.

Surgical Biopsy

Doctors often recommend a minimally invasive biopsyinfo-icon as a first option. Your doctor may recommend a surgical biopsyinfo-icon if:

  • You already had a needle biopsyinfo-icon but more information is needed
  • They believe a needle biopsy won’t give enough information

A surgical biopsy may be called either an incisional biopsyinfo-icon or excisional biopsyinfo-icon.

  • During an incisional biopsy, a surgeoninfo-icon removes part of the abnormalinfo-icon area to make a diagnosisinfo-icon.
  • In an excisional biopsy, a surgeon tries to remove the entire abnormal area. An excisional biopsy if often used when the doctor suspects there may not be cancer. When cancer is found, it is likely you will need another procedure. In cases where the area is benign, often no more surgeryinfo-icon is needed.

Surgical biopsies are done in an operating room. Most people are put to sleep for the procedure. Sometimes this involves “twilight” anesthesiainfo-icon and sometimes general anesthesiainfo-icon. There are small differences in both, so speak with your surgeon about your options.

Because the surgeon uses a scalpelinfo-icon to cut into your breast to remove the abnormal tissueinfo-icon, you will need stitches. These procedures cause a scar, and you may need a couple of weeks to heal.

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