Breast Biopsy

What is a breast biopsy?

A breast biopsy is a procedure that removes a sample of breast tissue so that it can be checked for signs of disease. A doctor called a pathologist looks at the tissue under a microscope to diagnose breast cancer and other breast diseases.

Breast cancer is cancer that forms in the milk ducts (tubes that carry milk to the nipple) and the lobules (the small lobes of breast tissue that make milk). Breast cancer is much more common in women, but men can get it, too. Not much is known about breast cancer risk in transgender people. If you are transgender, talk with your provider about your risk.

There are different ways to do a breast biopsy. Some methods remove breast tissue with a needle and others use a small incision (cut) in your skin to remove part or all of the suspicious tissue.

Most people who need a breast biopsy don't have cancer.

Other names: core needle biopsy; core biopsy, breast; fine-needle aspiration; open surgery biopsy

What is it used for?

A breast biopsy is the only way to find out whether a suspicious change in your breast is cancer. You may have a biopsy after other breast tests, such as a physical breast exam or a mammogram, show signs that could be breast cancer.

Why do I need a breast biopsy?

You may need a breast biopsy if:

• You or your health care provider felt a lump, thickening, or other change in your breast.
• A mammogram, ultrasound, or MRI test shows a lump, calcium deposits, or other signs that might mean cancer.
• The skin on your breast or nipple is red, scaly, or swollen, or your nipple is pulled inward.
• You have a discharge of abnormal fluid coming from your nipple.

If your provider suggests that you have a breast biopsy, it doesn't mean you have breast cancer. Most breast lumps and other changes that are checked with biopsies turn out to be benign, which means they are not cancer.

What happens during a breast biopsy?

There are three main types of breast biopsy procedures. They are usually done on an outpatient basis, which means you go home the same day:

• Fine needle aspiration biopsy uses a very thin needle to remove a sample of breast cells or fluid. The biopsy takes about 15 minutes.
• Core needle biopsy uses a wide needle to remove one or more small tissue samples about the size of a grain of rice. Sometimes a small vacuum probe is used instead of a needle. The device gently suctions some tissue and removes it with a small rotating blade. A core needle biopsy takes between 15 minutes and an hour, depending on how it's done.
• Surgical biopsy (or open biopsy) is surgery to remove all or part of a lump. The biopsy usually takes about an hour.

Biopsies are often done using mammography, ultrasound, MRI, or x-rays to help see exactly where to take the tissue sample. Your procedure will vary depending on which method is used to guide the biopsy, but the general steps are usually the same.

For a fine needle aspiration biopsy or a core needle biopsy:

• Your provider will clean the skin on your breast and give you a shot of medicine to numb the area, so you won't feel any pain. The shot may sting briefly.
• You may be sitting or lying down. If images are used to guide the biopsy, you may lie on your side, back, or belly with your breast over an opening on the table.
• For a fine needle aspiration biopsy, your provider will insert the needle into the biopsy site and remove a sample of cells or fluid. For a core biopsy, a tiny cut may be made to insert a wide needle or a vacuum device. You may feel a little pressure when the sample or samples are removed.
• Pressure will be applied to area until the bleeding stops.
• Your provider will cover the biopsy site with a sterile bandage. If you had a small incision, small strips of medical tape may be used to close the wound.

For a surgical biopsy:

• You'll lie on an operating table. You may have an IV (intravenous line) in your arm or hand that may be used to give you medicine to relax. The skin over the biopsy area will be cleaned.
• To prevent pain, you'll have either:
  • A shot of medicine to numb your breast. The shot may sting briefly.
  • General anesthesia, which is medicine given through an IV to make you sleep.
• When you are numb or asleep, the surgeon will make a small cut in your breast tissue to remove part or all of the lump. In certain cases, tissue around the lump may also be removed. This may help avoid the need for more surgery if cancer cells are found in the lump.
• The cut in your skin will be closed with small strips of medical tape or stitches and covered with a sterile bandage.

The type of biopsy you have will depend on:

• The size and location of the suspicious tissue in your breast
• How many areas of your breast are involved
• How abnormal the tissue looks on a mammogram or other image
• Your general health and preferences

Ask your provider about why you need a biopsy and which type is right for you.

Will I need to do anything to prepare for the test?

Your provider will give you instructions for how to prepare for your biopsy. If you take any blood thinners, including aspirin, you may need to stop taking them before your biopsy. Tell your provider about all the medicines and supplements you take. Don't stop or start taking anything without talking with your provider first.

If you're having general anesthesia, you will probably need to fast (not eat or drink) for several hours before surgery. If you have general anesthesia or medicine to relax, you may be groggy after the procedure, so plan to have someone take you home.

Are there any risks to the test?

It's common to have some bruising and temporary discomfort after a breast biopsy. Possible risks include:

• Infection, which can be treated with antibiotics
• Bleeding

Your provider will give you instructions for how to care for biopsy area and manage any discomfort. If you're having general anesthesia, talk with your provider about how it may affect you. General anesthesia is very safe even for most people with other health conditions.

What do the results mean?

It may take several days to a week to get your biopsy results. The results are called a pathology report. The report is written for your provider and will include a lot of medical terms. Your provider can explain what your report means.

The most important part of your report will be the diagnosis. In general, your results will be one of these categories:

• Normal. No cancer or abnormal cells were found.
• Abnormal breast changes that aren't cancer and don't increase your risk for breast cancer. Some of these conditions often get better on their own and others may need treatment.

• Abnormal breast changes that increase your risk for breast cancer. These cells are not cancer, but if you have them, you are more likely to develop cancer.

  If you had a needle biopsy that diagnosed a condition that increases your breast cancer risk, you may need a surgical biopsy to remove all the abnormal tissue. To find out what you can do to reduce your breast cancer risk, you will likely see a doctor who specializes in breast cancer.

• Breast cancer. If your biopsy finds cancer cells, your report will include details about how fast the cancer cells are growing, how much they look like normal cells, and other information to help plan the most effective treatment for your type of cancer. Usually, a doctor who specializes in breast cancer will provide your care.

Learn more about laboratory tests, reference ranges, and understanding results.