Breast Biopsy

Understanding Breast Biopsy

Your doctor has recommended that you have a breast biopsy. Breast biopsy is performed to further evaluate a breast lump that can be felt or that has been identified by mammogram or ultrasound. The biopsy helps determine if the area of concern is cancer.

Types of Breast Biopsy

There are several ways that a biopsy can be performed. The method chosen for you depends on how the area of concern is best identified.

Excisional Biopsy

An excisional biopsy is done in the operating room for a lump that can be easily felt by your surgeon. You will be under sedation and monitored by an anesthesiologist. The area over the lump will be anesthetized with local anesthetic and a small incision will be made. The lump will be removed and sent to the lab for analysis.

Stereotactic Biopsy

The type of biopsy is performed for abnormalities best seen on mammogram. It is done with a special needle through a very small skin incision. Only local anesthetic is needed; you will not need to be sedated. There is minimal pain with the procedure. The biopsy is performed at a facility that has the appropriate equipment.

You will be asked to lay face down on a table. Your breast will be placed through an opening in the table and mammograms will be made. The skin will be anesthetized with a local anesthetic and a very small incision will be made. Using the images and the assistance of a computer, a biopsy needle will be positioned in the area of concern and biopsies will be taken.

The needle is then removed and a tiny metallic clip may be placed to mark the biopsy for future reference.

Ultrasound Guided Biopsy

This type of biopsy is performed for abnormalities best seen by ultrasound. It is done with the same type of needle as a stereotactic biopsy. Instead of using a mammogram to guide the positioning of the needle, an ultrasound probe is used. Again, the biopsy is performed at a facility with the appropriate equipment. You will lie on your back and the area of concern will be identified with the ultrasound. Under local anesthetic, the biopsy needle will be positioned and biopsies will be taken. A marking clip may be placed.

Needle Localization Biopsy

In certain cases, a needle localization procedure may be recommended. This is a two-part procedure. First, instead of going directly to the operating room, you will be taken to the mammography area. A mammogram machine will be used to determine the exact location of the tissue under study.

A localization needle will be inserted using the mammogram for guidance. When the needle is in the correct position, a small guide wire will be inserted through the needle to mark the position of the abnormality and the needle withdrawn. The wire will then be taped to your skin. You will be returned to the preoperative area to await transfer to the operating room. Your surgeon will use the wire as a guide to the area in question.

Recovery

After surgery, you will be taken to the recovery area where a nurse will monitor your progress. Once you are consuming fluids and feel comfortable leaving, you will be discharged. If you had an excisional biopsy under sedation, you must have someone drive you home.

Discharge Instructions

Wear a bra to bed as well as during the day for the first week. Sports bras are especially comfortable for this purpose. An ice pack will help to decrease the swelling. Usually, over-the-counter medication such as Advil or Tylenol will provide sufficient relief for a needle biopsy. If you had an excisional biopsy, you will be given a prescription for a stronger painkiller. You may resume normal activities, including showering, the next day. Avoid exercise until cleared by physician. The biopsy results should be available 1 to 3 days after the procedure. Make an appointment to see your surgeon a week after the biopsy to examine the biopsy site and to discuss the biopsy results.

Don’t remove the steri-strips placed over  the incision. They usually fall off after 7-10 days.

Risks of the Procedures

Complications of the procedures are not common, but can include bleeding, infection, scarring, inability to biopsy the areas in question for technical reasons, a false negative result, complications related to anesthesia, and others.

Call your Surgeon if:

  • You have any bleeding other than a small spot on the dressing.
  • You experience severe pain or swelling of the breast.
  • You develop a fever over 100.4 degrees.

Click here to know more about Post-Operative Breast Biopsy.