If you're like some people, the prospect of a breast biopsy may make you feel slightly unnerved, or even scared. For most patients, however, the anticipation of a breast biopsy can be more intimidating than the procedure itself.
What is a biopsy?
A breast biopsy involves your doctor, usually a radiologist, obtaining a small sample of breast tissue through a minimally invasive procedure for evaluation in the laboratory. An evaluation is performed because medical imaging or physical examination has prompted a doctor to be concerned about the characteristics of that tissue.
Why is a breast biopsy needed?
In the most typical situation, your radiologist sees something concerning on your images taken during your screening mammogram or ultrasound exam. This might be a lesion or what are known as calcifications—tiny white specks visible within the breast—that the radiologist can't determine is non-cancerous without further testing.
"We only biopsy lesions that we can't say for sure are benign," explained Linda Greer, MD, medical director for the HonorHealth Breast Health and Research Center. Some lesions obviously look like cancer, she noted, but others appear fairly benign, yet grew rapidly or unexpectedly.
Doctors also biopsy:
- A mass or lesion recently noticed by the patient or a doctor, because it's assumed the mass has grown since it wasn't noticed before.
- Clustered calcifications, because they can be an early sign of cancer. Most calcifications, however, are what doctors consider benign fibrocystic changes.
The radiologist who reads your mammogram or ultrasound examination, in consultation with your primary care physician, may recommend that a biopsy be performed if an area within the breast appears to be abnormal.
In most cases, you will make an appointment for a biopsy; typically, it's performed within a few weeks of your imaging exam.
How is a breast biopsy performed?
One of the most common types of biopsy is a core-needle biopsy. In most cases, a breast biopsy is performed in a radiology office, with the help of medical imaging, Dr. Greer said. Here's what you should expect:
- If a lesion is discovered through a mammogram, then your biopsy most likely will involve mammography.
- If an area of concern is identified with ultrasound or magnetic resonance imaging (MRI), ultrasound or MRI will be used to guide your biopsy, respectively.
- A doctor, typically a radiologist, uses local anesthetic to numb the breast area that is to be sampled.
- The doctor inserts a small, hollow needle into the breast and takes several samples quickly.
- The samples are sent to the pathology lab for evaluation.
- Almost always, a small metal clip is left behind in the breast to mark the biopsied site. (The marker causes no problems for the patient.)
"It's really a quick procedure," Dr. Greer said. "Usually the most irritating part is the numbing, just like for dental work. There is minimal bruising typically."
The biopsy site will be bandaged and you'll be given an ice pack to minimize bruising and mild discomfort. You'll be sent home within an hour or so of the procedure.
You'll typically be notified of the biopsy results within a few days.