Breast Biopsy
(Breast Needle Aspiration)
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Definition
Breast biopsy is the removal of a sample of breast tissue. The removed tissue is then examined in a laboratory. A breast biopsy is done by:
- Needle aspiration—a needle is inserted into a lump, and fluid and/or tissue is removed for examination
- Open biopsy—an incision is made into the breast, and a piece of tissue or the entire lump is removed for examination
Needle Aspiration
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Reasons for Procedure
A breast biopsy is done to examine a suspicious area in the breast. The biopsy can identify the area as either benign (noncancerous) or malignant (cancerous). It may be done if any of the following are found:
- A lump
- Tissue thickening
- Calcification
- Nipple abnormality
- Discharge from the nipple
- Abnormal ultrasound or mammogram image
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam, especially breast exam
- Blood tests
- Mammogram and/or breast ultrasound
In the days leading up to your procedure:
- The night before, eat a light meal and do not eat or drink anything after midnight
- You may be asked to shower the morning of your procedure with a special antibacterial soap
Anesthesia
May be local for needle aspiration or general anesthesia for open biopsy
Description of the Procedure
Needle Aspiration
The skin over the area is cleaned. A local anesthetic may be injected. The biopsy needle is inserted and fluid and/or tissue is removed. The biopsy needle may be removed and re-inserted several times to get samples from different locations. When the needle is removed for the last time, pressure is applied to the area briefly. The puncture spot is covered with a small pressure bandage.
Open Biopsy
You'll be given sedation and either general or local anesthesia to numb the area. The overlying skin is cleaned. A small incision is made over the area. A sample of the tissue or the entire lump is removed. The incision is then closed with either stitches or clips, and covered with a light pressure bandage.
Needle Localization
In some cases, the lump may be too deep within the breast to be felt by the examiner's fingers, but can be visualized by mammogram or ultrasound. A technique called "needle localization" is used. Once a mammogram, MRI, or ultrasound has located the precise location of the lump, a fine needle is placed into it. A guide wire may then be inserted through the needle into the location to be biopsied. A blue dye may be introduced as well to further guide the surgeon to the exact tissue requiring examination.
Large Core Needle Biopsy
You'll be given sedation and either general or local anesthesia to numb the area. You’ll lie on your stomach on a special table that has an opening for your breast. X-ray images will be taken from different angles to help locate the lump. A wire is inserted into the lump. The large bore needle used to remove the breast tissue is threaded over the wire. A cylinder of breast tissue is removed for examination.
After Procedure
The sample is examined by a pathologist.
How Long Will It Take?
1-3 hours
Will It Hurt?
Needle aspiration and wire localization will be slightly painful during the procedure. During open biopsy, anesthesia prevents pain.
Possible Complications
- Bleeding
- Infection
- Bruising
- Scarring
- Tissue damage
- Breast deformity
- Numbness over area of biopsy
Average Hospital Stay
None
Postoperative Care
- You will be given pain killers, either acetaminophen, ibuprofen, or prescription medications
- Warm compresses or a heating pad may also help relieve discomfort
- Wear a supportive bra
- Your doctor will let you know how often to change your bandages
- You'll need to restrict exercise for 2-3 weeks after your surgery
Outcome
You'll receive test results within 2-5 days after surgery. These results will tell you if the sampled breast tissue showed any signs of cancer. Your doctor will remove your stitches within a week of your biopsy.
Call Your Doctor If Any of the Following Occurs
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the biopsy site
- Nausea and/or vomiting that you can't control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
- Signs of infection, including fever and chills
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Pain and/or swelling in your feet, calves, or legs, sudden shortness of breath or chest pain
CANADIAN RESOURCES:
Canadian Breast Cancer Foundation
http://www.cbcf.org/
Canadian Cancer Society
http://www.cancer.ca/
References:
Biopsy. The Breastcancer.org website. Available at: http://www.breastcancer.org/symptoms/testing/biopsy.jsp. Accessed February 19, 2008.
Pfenninger JL, Fowler GC. Procedures for Primary Care Physicians. 1st ed. St. Louis, MO: Mosby-Year Book; 1994.
Sabiston DC, Lyerly HK. Textbook of Surgery. 15th ed. Philadelphia, PA: WB Saunders Co.; 1997.
Last reviewed March 2008 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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