Two-step procedure

Most women have biopsies in the hospital outpatient or "same day surgery" department. They usually do not need to stay overnight. Your doctor or nurse will tell you if you may eat or drink before surgery. At the hospital, you will have some routine tests such as blood and urine tests, a chest x-ray, and an EKG (electrocardiogram), which records the activity of your heart. These tests tell your doctor about your general health. Sometimes these tests are done a few days before the biopsy.

You will be asked to sign a paper called an "informed consent form." It explains what the doctor is going to do and gives your permission for the procedure. If you do not understand this form, be sure to ask the doctor or nurse to explain it to you.

When it is time for the biopsy, you will be taken to the operating room. You will be given local or general anesthesia. For local anesthesia, the doctor injects some medicine in the breast so you won't feel anything as the lump is removed. For general anesthesia, you will be put to sleep for a short time while the doctor removes the suspicious tissue. The doctor often removes all of the lump or area in question (excisional biopsy). This type of biopsy usually takes about an hour.

The pathologist then checks the tissue to see if it is cancer. Using a procedure called a frozen section, the pathologist looks at thin slices of frozen tissue under a microscope. It takes just a few minutes and is a quick way of telling if cancer is present. If the lump is very small or if a more detailed study is needed, the pathologist looks at the tissue using a procedure called a permanent section. The results of this test are usually known in a few days. From the permanent section the doctor can tell the type of breast cancer and learn other information that may be needed to plan treatment.

If the biopsy shows cancer and enough tissue is available, the pathologist does more tests called hormone receptor assays. These tests tell whether the cancer needs the female hormones, estrogen and progesterone, to grow. Doctors do hormone receptor assays at the time of the biopsy because the tissue needed for these tests may be hard to get later on. This information is important to help the doctor decide how the cancer should be treated.

After the biopsy, you will be taken to your room or the outpatient care area. Most women have very little discomfort after a biopsy. If you have general anesthesia, you will probably be sleepy and want to rest. Depending on how you feel, you will be ready to go home 2 to 3 hours after the biopsy. It's best for a family member or friend to take you home. Before leaving the hospital, you will get instructions on how to take care of the incision. If you have any questions, ask your doctor or nurse.

You should be able to return to your normal routine within a day or two. However, for the next week or so your breast may be sore and slightly bruised. Also, the incision may feel firm for 3 to 4 months.

You may be told the results of your biopsy before you leave the hospital. However, the results from a permanent section will take a few days. If you have cancer, your doctor will talk with you about treatment options. Treatment for breast cancer usually begins within a couple of weeks after the biopsy. This gives you time to:

• Learn about treatment options and breast reconstruction.
• Get another medical opinion.
• Have tests that tell if the cancer has spread to other parts of the body.
• Prepare yourself emotionally.
• Make personal and work arrangements.

A short delay between the biopsy and treatment will not reduce the chances that your treatment will be successful.