Surgical Care Group

Breast Biopsy

Why a Breast Biopsy?

Studies have shown that 50 percent of all women will either find a lump themselves or have a mammography report with a questionable finding.
Although 80 percent of all breast lumps or masses are benign (non-cancerous), it is important that any new or unexplained mass be evaluated by a healthcare provider. Unfortunately, a precise diagnosis often cannot be made without a biopsy being done.
There are different methods of obtaining a breast biopsy. Your physician can discuss your options with you and recommend which method is most appropriate for you.
Early detection of breast cancer can greatly increase the chance of successful treatment.

A Fine Needle Aspiration obtains cells from both solid and more commonly cystic masses.
The skin is first numbed with a local anesthetic, and a needle is inserted into the mass to withdraw some fluid or tissue. If fluid is obtained and it is typical for a benign cyst, it may be discarded. If the aspirated material is not typical for a benign cyst, cells from the aspiration are placed on a slide to be examined.

If a mass is palpable upon examination in the office, a Core Needle Biopsy can be done to immediately obtain tissue from the mass. A local anesthetic is injected near the mass. A special needle is then inserted into the mass, and a core sample of tissue is removed.
Generally, patients have minimal discomfort but some bruising may develop at the biopsy site.

Ultrasound Guided Biopsy is recommended when a mass is identified on ultrasound but is not clearly palpable.
Ultrasound uses painless sound waves generated by a hand held probe to produce an image of the breast and its structures on a monitor. This procedure can be done in our office. The patient lies on her back for the ultrasound examination. Gel is placed between the patient’s breast and the ultrasound probe. When the lump is imaged on the monitor, a local anesthetic is injected into the area. The ultrasound image then guides placement of either a fine needle or a core needle into the mass.
There may be some bruising afterwards with minimal discomfort.

Stereotactic Biopsy is often recommended for non-palpable abnormalities found on mammogram, such as microcalcifications.
The test is performed at the hospital by a radiologist using specialized mammogram equipment.
This procedure is performed on an outpatient basis under local anesthesia.
Mammography is used to localize the mass and to guide insertion of a core needle into it.
Some bruising may develop at the biopsy site, but usually there are no serious side effects.

Needle Localization allows complete excision of breast tissue associated with non-palpable abnormalities found on mammogram.
The patient first goes to the radiology department in a hospital where a thin wire is placed next to the mammographic abnormality. The wire identifies the abnormal tissue for the surgeon.
The patient then goes directly to the operating room where the localized tissue is excised.
This procedure is done under local anesthesia with sedation or rarely under general anesthesia, depending on the patient’s preference.
The incision is usually small and closed with sutures placed under the skin which dissolve.
An x-ray of the specimen is done to confirm that all the suspicious lesions seen on mammography have been removed.

If a mass is easily felt and is clearly different from the surrounding breast tissue, an open biopsy can be done to completely remove the mass. Some of these masses are benign, but it is impossible to tell by physical examination alone.
An open biopsy is typically performed on an outpatient basis in the operating room under local anesthesia with sedation or rarely under general anesthesia, depending on the patient’s preference.
Usually the incision is small and is closed with sutures under the skin which dissolve.

All biopsies are sent to the pathologist to be examined for irregular cells. Arrangements should be made for a follow-up appointment with your physician to discuss your biopsy results when they are available.