What to Expect During a Breast Biopsy

If your mammogram or other diagnostic test has come back with abnormal results, your surgeon could recommend a breast biopsy. During this procedure, the surgeon removes a sample of the abnormal tissue in your breast to determine if the abnormal cells are cancerous.

Having a breast biopsy can be scary, but it does not mean you have cancer. The biopsy will give your physicians the information they need to determine what care, if any, you may need in the future.

Read below to learn more about the different kinds of biopsies. Your surgeon will discuss which approach is best for you.

The Different Types of Breast Biopsies

Fine needle aspiration biopsy (FNA). This is the simplest kind of breast biopsy. It feels like getting a shot in your breast, but the procedure only takes a few minutes. An FNA may not always determine whether cancer is present, but the results can be very accurate when interpreted carefully by your surgeon and the pathologist (the doctor who looks at the cells and makes the diagnosis).

Mammotome Breast Biopsy System. The Mammotome system includes digital imaging, which allows doctors on the medical staff to clearly identify a breast abnormality, even in its earliest stages. Using a computer-guided Mammotome probe, your doctor can collect breast tissue samples through a small, quarter-inch incision.

Stereotactic needle core biopsy. During this procedure, the physician removes an actual core of tissue, not just cells. This test allows the pathologist to make a more definite diagnosis, but it is only used in certain situations. Be sure to discuss with your physician if this option is best for you.

Biopsy using sonography or mammography. Your physician could recommend that you see a radiologist for a biopsy using sonography or mammography. You will receive anesthesia (or numbing medicine) during these procedures.

"Open" or surgical biopsy. Your surgeon could recommend this procedure if there is an abnormal area on your mammogram, but you cannot feel the area on your breast. Before the biopsy itself, your surgeon could give you another mammogram with a fine wire placed in the abnormal area. This procedure, called a needle localization procedure, is performed with a local anesthetic to minimize any discomfort. The needle localization procedure allows your surgeon to find and remove just the abnormal tissue and some surrounding normal tissue, without having to remove any more tissue than necessary. During the open biopsy, the abnormal tissue or mass will be removed partially or completely, depending on its size and what is best for your overall care.

Anesthesia during the biopsy. Before the day of the biopsy, you and your surgeon should discuss which kind of anesthetic is best for you: a local anesthetic, which will allow you to remain awake during the procedure; a local anesthesia and sedation, which will relax you while you are conscious (you are relaxed, but still awake); or a general anesthetic, which will put you to sleep for the procedure.

Following up after a biopsy. After the procedure, your surgeon will send the tissue to a pathologist, who will examine it under a microscope. Your surgeon may have a preliminary diagnosis on the day of the surgery, but frequently it takes 48 hours or so until the pathologist gives the final report. You should talk with your surgeon about specifically how you would like to receive this report or information.

If preliminary results are not available the day of your biopsy, you may have at least one more visit with your surgeon to discuss the biopsy report and what it means. If the report shows the tissue is benign or non-cancerous, your surgeon may simply recommend routine follow-up with your primary medical doctor.

If the report is malignant or cancerous, then additional surgery, treatment and consultation may be necessary. You should discuss with the surgeon what should be done and what to expect from the treatment. Your surgeon could refer you to other cancer specialists, including a radiation oncologist or a medical oncologist.

The surgeon should call your primary physician with the results of your biopsy, and follow-up with a written report.