A biopsy involves taking a small amount of tissue from your breast. This tissue is then analyzed by a pathologist, 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 diagnosis and then creates your pathology report. 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.
During a minimally invasive biopsy, you’ll lie down and the doctor will find the abnormal area by feeling for a lump. If a lump cannot be felt, your doctor may use imaging machines like an ultrasound, mammogram or MRI to find the area. Many times the doctor will take multiple biopsies from the same area.
The least invasive kind of needle biopsy 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 tumor 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 lymph nodes.
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, mammography machine or MRI machine. When the biopsy is performed using a mammography machine, it is called a stereotactic core biopsy. 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.
- You already had a needle biopsy but more information is needed
- They believe a needle biopsy won’t give enough information
- During an incisional biopsy, a surgeon removes part of the abnormal area to make a diagnosis.
- 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 surgery is needed.
Surgical biopsies are done in an operating room. Most people are put to sleep for the procedure. Sometimes this involves “twilight” anesthesia and sometimes general anesthesia. There are small differences in both, so speak with your surgeon about your options.
You may hear people talk about having biopsies of their lymph nodes, tissues that are part of the immune system. The lymph nodes are often the first place breast cancer travels. Some people will undergo a fine needle aspiration of an abnormal lymph node, but most will have a surgical biopsy. This is called a sentinel lymph node biopsy or an axillary lymph node dissection.