Breast Biopsy

What is a breast biopsy?

A breast biopsy is a procedure for removal of a small piece of tissue from your breast. The tissue is studied under a microscope to look for cancer or other disease.

When is it used?

Your healthcare provider may do a breast biopsy if:

• You have a lump in your breast.
• You have an ultrasound scan that shows a possible tumor.
• Your mammogram shows an abnormal area.
• One of your nipples has an abnormality, such as crusting, sores, dimpling of the skin, or bleeding.

You can also choose not to have a biopsy, recognizing the risks of not knowing if an abnormal area is cancer. You should ask your healthcare provider about these choices.

How do I prepare for a breast biopsy?

• Your provider may ask you to bathe well before the biopsy. Give special attention to the area around your breasts and armpits.
• If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it and how long before the procedure.
• If you may be given a sedative, you should not eat or drink anything for 12 hours before surgery.
• Ask your healthcare provider when and how you will be told about the test results.

What happens during the procedure?

The type of biopsy you have depends on the kind of lump or abnormality your healthcare provider is testing you for. The biopsy may be done in the provider's office, an outpatient surgery clinic, or the hospital.

You may be given a local anesthetic. The anesthetic numbs just the skin and tissues that will be cut or punctured. You may also be given a sedative. A sedative helps you relax and may put you to sleep. Sometimes a breast biopsy can require general anesthesia.

The 2 main types of breast biopsies are:

• Needle biopsy

  Your provider removes a small amount of tissue from the abnormal area of your breast with a small needle. This is often done in your provider's office or in the mammography center. It may be guided by X-rays or ultrasound.

• Surgical biopsy (incisional or excisional)

  A piece of breast tissue is cut out. This type of biopsy may be done in an outpatient surgery clinic or hospital. Before surgery you may be sent to the X-ray department so your breast can be marked with a small wire placed in the abnormal area.

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 healthcare provider may explain what the lump probably is. The lab will usually complete its final testing of the lump within 1 week, and your provider may be able to give you the diagnosis.

After surgery, you should avoid strenuous activities for a few days to prevent bleeding. You may have swelling or bruising around the biopsy site. This will usually go away in 2 to 3 weeks.

If you have stitches, try to keep your wound dry when you bathe to prevent infection.

In the future it may be hard for you to feel any new lumps in the biopsied area because scar tissue may have formed. You may also have a small ridge on your breast caused by scar tissue and stitches. After your breast heals, ask your healthcare provider to show you how to do breast self-exams so you can tell the difference between scar tissue and new lumps.

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

What are the benefits of this procedure?

The biopsy helps your provider find out whether the abnormal area in the breast is cancerous or noncancerous. If it is cancerous, you and your provider will decide on a treatment plan. If it is not cancerous, your provider may suggest ways to prevent some noncancerous diseases from recurring.

What are the risks associated with this procedure?

• 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 the anesthesia. Local anesthesia alone is safer than local anesthesia with sedation.
• There are some risks when you have sedation. Discuss these risks with your healthcare provider.
• You may have bruising around the biopsy site.
• You may have infection or bleeding at the site of the biopsy.

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

When should I call my healthcare provider?

Call your provider right away if:

• You have a fever of 100.5°F (38°C) or higher.
• Your pain or symptoms get worse.
• You have any unusual drainage from the biopsy site, including bloody drainage.
• The biopsy site becomes red or warm.

Call during office hours if:

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