What to Expect: Breast Biopsy

Your physician has ordered a breast biopsy. Now what happens?

You may have felt a lump in your breast or an abnormality appeared on your mammogram and your physician has ordered a biopsy. It is only natural to be anxious and frightened. Relax. Not all lumps and abnormalities are cancerous. It could be a benign (non-cancerous) breast condition. Most benign breast conditions are common and are not life-threatening. A breast biopsy is the only way to obtain an accurate diagnosis as to whether a lump is benign or cancerous.

Benign Breast Conditions
Some women may notice changes in their breasts just prior to their menstrual periods because hormones affect the breast tissue. Many people who have breast biopsies are found to have benign changes in the breast tissue such as fibrosis and cysts. These lumps and thickening of the breast tissue are almost always harmless. Fibrosis and cysts can cause lumpiness, thickening or tenderness, nipple discharge or pain.

Fibrosis: firmness in the connective tissue of the breast.

Cysts: fluid-filled sacs. They can be diagnosed with a breast ultrasound or a sample of the fluid can be removed with a needle. More testing may be required if the cyst has any solid areas. The size, shape and edges of the lump are examined and the physician will determine if it requires a biopsy.

Benign breast tumors: solid lumps or non-cancerous areas where breast cells have grown abnormally and quickly. While they may be painful, benign breast tumors are not dangerous and do not spread to other organs.

Fat necrosis: may occur if a breast injury heals and leaves scar tissue that feels like a lump.

Duct ectasia: a green, black, thick or sticky discharge from the nipple is common among women in their 40s and 50s. It can cause tenderness or redness of the nipple and surrounding area as well as a hard lump. A biopsy is typically performed to rule out cancer.

Breast Biopsy photo

What are the different types of breast biopsies and what happens during each procedure?

A breast biopsy is performed to remove cells - either surgically or less invasively with a hollow needle - to determine if an abnormality is benign (non-cancerous) or cancerous. MVH's Breast Care Center offers different types of breast biopsy procedures to obtain tissue samples. The type of biopsy a physician prescribes largely depends on the size, location and other characteristics of the breast abnormality.

Magnetic Resonance Imaging (MRI)-Guided Breast Biopsy
When an MRI reveals an abnormality, an MRI-guided breast biopsy can help yield a diagnosis. The biopsy, which is performed at MVH's Breast Care Center, is minimally invasive and takes approximately one hour. During the procedure, computer technology guides a needle to the mass. A tissue specimen is removed and sent to the on-site lab where it will be tested.

Stereotactic Breast Biopsy
When a mammogram shows an abnormality which cannot be felt, the radiologist may suggest a stereotactic core biopsy be performed. A stereotactic biopsy is a less invasive way to obtain breast tissue samples. The test uses X-ray equipment and a special computer to analyze pictures of the breast. The computer precisely identifies the abnormal area in which to insert the needle for the removal of a tissue specimen. A stereotactic breast biopsy provides the most accurate results. The procedure requires less recovery time than a surgical biopsy and it leaves no significant scarring to the breast.

Ultrasound-Guided Breast Biopsy
An ultrasound-guided breast biopsy uses high-frequency sound waves to produce precise images of the abnormality on a computer screen. Once the mass is located, a small incision is made to insert a needle that removes several core samples of tissue to be sent to the on-site lab for analysis.

Surgical (Open) Biopsy
Most physicians prefer to prescribe the less invasive methods of breast biopsy—MRI-guided, stereotactic or ultrasound-guided—however, there are times when a surgical breast biopsy is necessary. Also called an open biopsy, this method is performed by cutting the breast to remove the lump to review it under a microscope. The two types of surgical biopsies include:

  • Incisional: which removes a portion of the abnormality
  • Excisional: which removes the entire abnormal areas

A surgical biopsy is performed in the hospital on an outpatient basis. Typically, the person is awake and given a local anesthetic to numb the breast. In some instances, general anesthesia is used. Surgical biopsies often require stitches that will leave a scar. They can cause bleeding and swelling, In addition, if a large portion of tissue is removed, the shape of the breast may change.

Biopsy Markers
Regardless of the type of biopsy performed, the physician may insert a tiny metal device in the breast to mark the biopsy site. The tiny marker cannot be felt and will be present on future mammograms to help view any future changes.

What happens after the tissue is removed?

Once the tissue is removed, it is sent to the on-site Pathology Department. A pathologist will perform tests on the tissue and examine it under the microscope. A pathologist is a physician who specializes in the diagnosis and classification of diseases in the lab by testing and examining cells under a microscope. The pathologist will determine if a tissue sample is benign or cancerous.

How long will I have to wait for the results?

Waiting for the results may be the most difficult part of the entire biopsy process. It is normal to feel a wide spectrum of emotions during the wait. Due to the time required to generate accurate results in pathology, diagnosis is typically available within three to four days.

Who do I contact if I have questions?

Our nurse navigator is available to answer your questions at 724-258-1669. A nurse navigator is a registered nurse who is specially trained to assist with every step of care. For patients diagnosed with breast cancer, the nurse navigator offers three stages of support:

  • Information about treatment: when breast cancer is diagnosed, the nurse navigator helps to answer questions and coordinates care
  • Screening and diagnostics: the navigator helps explain procedures and results and offers breast health education
  • Survivorship: nurse navigators also provide education about maintaining health after treatment
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