Patient education: Breast biopsy (The Basics)

What is a breast biopsy? — A breast biopsy is procedure that checks an abnormal area of the breast for cancer or other problems. Biopsy can involve the breast tissue, a lymph node, or the skin.

You might get a breast biopsy if you or your doctor can feel a change in your breast, or if an area looks abnormal on an imaging test. Imaging tests create pictures of the inside of the body. They include breast ultrasound, mammogram, and MRI scan.

What happens during a breast biopsy? — Your experience will depend on the type of biopsy you have. The choice is based on:

●The size and location of the abnormal area

●What the abnormal area looks like on your ultrasound, mammogram, or MRI

Doctors can remove tissue for biopsy through a needle or through surgery. For all breast biopsies, you will get an injection (shot) first to numb the area.

The 3 main types of biopsies are:

●Fine-needle biopsy – The doctor uses a very small needle to remove a small amount of tissue or fluid from the abnormal area.

●Core needle biopsy – The doctor uses a larger needle with a special tip. The doctor will also often use special imaging equipment to find the abnormal area to take the biopsy. There are different ways to do this:

•Ultrasound-guided biopsy – You lie on your back or side, and the doctor holds the ultrasound device against your breast to guide the needle (figure 1).

•Stereotactic biopsy – You typically lie face down on a table. The table has an opening for your breast, which is pressed between 2 metal plates, just like during a mammogram. During this type of biopsy, the doctor takes an X-ray to decide where to insert the needle (figure 2).

•Tomosynthesis-guided biopsy – This also involves using X-rays to help guide the needle, as with a stereotactic biopsy. It requires a special machine that takes multiple X-rays to create a three-dimensional image of your breast. This is also called a "3D mammogram."

•MRI-guided biopsy – The doctor uses an MRI scan to decide where to take the biopsy. MRI uses a special type of magnet to create pictures of the breast.

After a core needle biopsy, your doctor will place a tiny piece of metal, called a clip, in your breast. The clip can be seen on an ultrasound or X-ray, so that in the future, doctors can see where the biopsy was taken. You cannot feel the clip and it will not cause problems during future imaging tests, including airport screening tests.

●Surgical biopsy – This is done in the operating room under anesthesia. The surgeon makes a small cut (incision) in your breast and takes out the abnormal tissue. Afterward, they take a special X-ray to make sure that the abnormal area was completely removed.

What happens after a breast biopsy? — After a biopsy, you might have bruising, bleeding, or get an infection. These problems are less common with fine- or core needle biopsy than after a surgical biopsy.

You will likely get the results of your biopsy in about a week. Your doctor will talk to you about what the results mean and what will happen next. If the results are not clear, your doctor will schedule another biopsy or procedure to get more information.

More on this topic

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Patient education: Breast cancer (The Basics)
Patient education: Common breast problems (The Basics)
Patient education: Breast ultrasound (The Basics)
Patient education: Mammogram (The Basics)

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