Breast Biopsy

A biopsy is a small piece of tissue that' s taken out and checked in a lab. For a breast biopsy, breast tissue may be removed with a special biopsy needle. It might also be removed during surgery. It' s checked to see if cancer or other abnormal cells are present.

Breast biopsies may be done:

• To check a lump or mass that can be felt in the breast

• To check a problem seen on a mammogram, such as small calcium deposits in breast tissue (microcalcifications) or a fluid-filled mass (cyst)

• To evaluate nipple problems, such as a bloody discharge from the nipple

• To find out if a breast lump or mass is cancer (malignant) or not cancer (benign)

A lump or other area of concern in the breast may be caused by cancer. Or it may be caused by another less serious problem. Many times, a biopsy is the only way to know for sure.

There may be other reasons for your doctor to recommend a breast biopsy.

All procedures have some risk. Some possible complications of a breast biopsy include:

• Bruising and mild pain at the biopsy site

• Prolonged bleeding from the biopsy site

• Infection near the biopsy site

If the biopsy is done using an X-ray, the amount of radiation used is small. The risk for radiation exposure is very low.

You may have other risks depending on your overall health. Be sure to discuss any concerns with your healthcare provider before the biopsy is done.

Your provider will explain the procedure to you. Ask any questions you have about the procedure.

• You'll be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if any thing isn't clear.

• In most cases , you don’t need to prepare for a biopsy if your breast is numbed (local anesthesia) but you are awake. But if you're given medicine to put you into a deep sleep (general anesthesia), you must not eat or drink anything for some time before the surgery. Your surgeon will give you specific instructions.

• Don’t use lotion, cream, powder, deodorant, or perfume on your arm, underarm, or breast on the day of the procedure.

• Tell your provider if you are pregnant or think you may be pregnant.

• Tell your provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general).

• Tell your provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.

• Tell your provider if you have a history of bleeding disorders. Let your provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the biopsy.

• If you have a sedative or general anesthesia, make sure you have someone drive you home afterward. You will not be able to drive after the biopsy.

• Your healthcare provider may have other instructions for you based on your medical condition.

A breast biopsy may be done in a provider’s office. It may be done on an outpatient basis, which means you go home the same day. Or it may be done as a hospital stay. Some types of biopsies only need local anesthesia. For other types, general anesthesia is needed. Procedures may vary depending on your condition and your provider’s practices.

Generally, a needle breast biopsy follows this process:

1. You 'll be asked to remove any clothing from the waist up and will be given a gown to wear.

2. You may lie down or sit up. It depends on your provider’s preference and if X-ray or ultrasound guidance will be used.

3. The skin over the biopsy site will be cleaned with a sterile solution.

4. When a local anesthetic is used, you'll feel a needle stick when the medicine is injected. You may feel a brief stinging when the medicine is put in. The biopsy will not start until the area is numb.

5. When ultrasound is used, the provider will move the probe over your breast to find the breast lump or mass.

6. When stereotactic imaging is used, you'll lie face down with your breast placed in an opening on the table. A computer will find the exact site of the breast lump or area of concern.

7. You will need to lie very still during the procedure. But you won’t need to hold your breath. 

8. The provider will put the needle right into the biopsy site or through a tiny cut (incision). He or she will remove a small sample of tissue or fluid. You may feel pressure when the doctor takes the sample.

9. Pressure will be applied to the biopsy site until the bleeding stops.

10. If needed, the opening will be closed with stitches or adhesive strips.

11. A sterile bandage or dressing will be used to cover the site .

12. The tissue sample(s) will be sent to the lab.

Generally, an open breast biopsy will follow this process:

1. You'll be asked to remove your clothing and will be given a gown to wear.

2. An IV (intravenous) line may be started in your arm or hand.

3. You'll be placed on the operating table.

4. You may be given medicine (a sedative) to relax you.

5. If local anesthesia is given, you 'll feel a needle stick to numb your breast tissue.

6. If general anesthesia is given, the anesthesiologist will keep checking your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

7. In some cases, a special wire will be put into the lump before the biopsy, guided by X-ray images. This is to help the doctor find the breast lump or mass. Other X-ray-guided methods may be used, too.

8. The skin over the surgical site will be cleaned with a sterile solution.

9. The provider will make a small cut in your skin and underlying breast tissue until the lump or mass is exposed.

10. A part of the lump or the full lump will be removed.

11. The opening will be closed with stitches or adhesive strips.

12. A sterile dressing or bandage will be applied.

13. The tissue will be sent to the lab for testing.

How long it takes to recover will depend on the type of biopsy you had and the type of anesthesia used.

If you had general anesthesia, you'll be taken to the recovery room, where you'll be watched closely. Once your blood pressure, pulse, and breathing are stable and you're alert, you will be taken to your hospital room. Or you will go home. If the biopsy was done on an outpatient basis, you should plan to have another person drive you home.

If you had local anesthesia, you'll be able to go home after you have recovered.

Before you agree to a test or procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure