Breast Biopsy
What is a breast biopsy?
A breast biopsy is a diagnostic procedure used to collect samples of breast tissue for examination under a microscope by a pathologist. Two types of breast biopsies are used to extract tissue samples. They are Stereotactic Breast Biopsy and Ultrasound-Guided Breast Biopsy.
Stereotactic Breast Biopsy is prescribed when an X-ray of the breast tissue called a Mammogram shows a mass, a cluster of microcalcifications, or an area of abnormal tissue without necessarily feeling a lump during a careful breast examination. Ultrasound Guided Breast Biopsy is prescribed when suspicious masses within the breast are visible on ultrasound.
How does it work?
Stereotactic breast biopsy is a minimally invasive procedure that uses special three-dimensional computerized imaging to pinpoint suspicious areas in the breast so that tissue samples may be withdrawn with a needle. Ultrasound-guided breast biopsy is an alternate procedure that uses sound waves to pinpoint suspicious areas in the breast.
In either procedure, a biopsy needle is used to remove samples of tissue for examination. An inner needle with a trough extending from it at one end is covered by a sheath and attached to a spring-loaded mechanism. When the mechanism is activated, the needle moves forward, filling the trough with breast tissue. The outer sheath instantly moves forward to cut the tissue and keep it in the trough. It takes only a fraction of a second to obtain a sample. For each sample it is necessary to withdraw the needle to collect the tissue. Tissue is obtained in an orderly manner by rotating the needle, ensuring that the entire region of interest will be sampled.
Why would you need this exam?
Regular mammograms as prescribed by your doctor are excellent to detect breast abnormalities. However, it is not always possible to tell from a mammogram alone whether an abnormality is benign or cancerous. To make this determination it is necessary to obtain a tissue sample for microscopic examination by a pathologist. Stereotactic and ultrasound-guided biopsies are alternatives to open surgical biopsy, which removes a larger specimen for microscopic analysis. These procedures are much less invasive than surgery and the sample of breast tissue obtained in this way is generally enough to show whether cancer is present.
Pre-exam instructions for a breast biopsy
We recommend that you wear a two-piece outfit for your exam. Please do not wear deodorant, lotion, powder, or perfume under your arms or on your breasts on the day of your procedure. Although Stereotactic and Ultrasound-guided biopsies are considered to be minimally invasive, some bleeding does occur. Therefore, if you are taking aspirin, aspirin-like medications such as Advil or Motrin, or a blood thinner, your physician may want you to stop five days in advance of the biopsy. We suggest that you have someone drive you to and from the exam. You can eat a light meal prior to the procedure.
The day of your exam
On the day of your exam, please arrive 15 minutes prior to your appointment time to check in and complete the necessary forms. Please be sure to have your insurance information ready and available. Once you have registered, you be will escorted to a changing area.
The procedure will be preformed by one of our Radiologists with assistance from a technologist or medical assistant. You will be given a local anesthetic for pain and remain awake throughout the entire procedure. If you are having a Stereotactic breast biopsy, you will lay on your abdomen with your breast gently placed through an opening in the table. The table will be raised up and the biopsy done below the table. Your breast will be compressed using a paddle-shaped instrument, just like a mammogram. The technologist will take two or three different images from different angles to locate the suspicious area on a computer screen. Our Radiologist uses these images to place the needle in the area to be sampled.
If you are having an ultrasound-guided breast biopsy, you will lie on your back or slightly to one side on the examination table. Your breast will be cleaned and a clear gel applied to your skin. Using the ultrasound wand, our radiologist will locate the suspicious area and begin the procedure.
A very small incision is made in the skin at the site where the biopsy needle is to be inserted. The doctor guides a hollow core biopsy needle or the vacuum-assisted needle directly into the mass and obtains tissue specimens. Usually multiple samples are taken from the area. If the suspected area is nearly or completely removed during the biopsy procedure, a clip is placed where the tissue was located to ensure that the site can be easily found if the samples prove to be cancerous. If a clip is placed in the breast, a two-view mammogram will follow the biopsy. After completion, a sterile dressing is used as a bandage to close the incision. The entire process takes approximately an hour to complete.
After your exam
You can return to normal activities including resuming any medication you were asked not to take after your exam. You should avoid strenuous activity for at least 48 hours and keep the wound dry for 24 hours.
A pathologist will examine the tissue specimens and will send a signed report with the findings to us and your doctor within one to three days.
Breast biopsy side effects
Most women feel fine after their procedure. It's a good idea to go home and relax for the rest of the day and avoid exercise or strenuous activity for 48 hours. In some cases, you may experience some bruising and mild discomfort. You can use a cold compress to help minimize swelling and tenderness of the biopsy area.