Incisional Breast Biopsy

What is an incisional breast biopsy?

An incisional breast biopsy is surgery to remove part of a lump in your breast for testing.

When is it used?

The biopsy is done to check if the lump is benign or cancerous. This type of biopsy is done when the lump is too large to be removed completely without major surgery, such as a mastectomy.

A disadvantage of this type of biopsy is that the entire lump is not removed. Additional surgery or other treatment will be necessary if cancer is found.

An alternative method for biopsy is needle core biopsy, which involves taking a tissue sample from the lump with a needle.

You may choose not to have a biopsy but then you have the risk of not knowing if the lump is cancerous. You should ask your health care provider about these choices.

How do I prepare for an incisional breast biopsy?

• You should bathe well before the biopsy. Give special attention to the area around your breasts and armpits.
• Tell your provider if you take aspirin or any medicine with aspirin in it. Stop these medicines at least a week before surgery.
• If you will be given a sedative at the time of the procedure, you should not eat or drink anything for 12 hours before surgery.
• Ask your health care provider when and how you will be informed of the results.

What happens during the procedure?

You are given a local anesthetic. The anesthetic numbs just the skin and tissues that are to be cut. You may also be given a sedative. A sedative helps you relax and may put you to sleep.

The surgeon will make a small cut in your breast and remove a sample of tissue. The surgeon will then close the cut with stitches. The sample will be sent to the lab for tests.

What happens after the procedure?

You may be observed for about an hour and then go home. During this time, an analysis may come back from the lab and your health care provider may explain what the lump probably is. This analysis is called a frozen section. In about 2 days, the lab may complete its final testing of the lump, and your provider may then be more certain of the diagnosis.

If the test results find that the tumor is benign, your surgeon may advise another biopsy to be certain. This is especially true if physical examination or mammograms show that the mass is probably malignant.

Ask your health care provider what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

This procedure will help your health care provider make an accurate diagnosis and recommend treatment if necessary.

What are the risks associated with this procedure?

• There are some risks when you have sedation. Discuss these risks with your health care provider.
• The local anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia alone is safer than local anesthesia with sedation.
• A lumpy scar called a keloid could form in the area of the incision.
• You may have infection and bleeding at the site of the incision.

You should ask your health care provider how these risks apply to you.

When should I call my health care provider?

Call your provider right away if:

• Your pain or symptoms get worse.
• You have any unusual drainage from the biopsy site, including bloody drainage.
• The biopsy site becomes red and warm.
• You develop a fever.

Call your provider during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.