Breast Biopsies: Everything You Need to Know

If you’ve found a questionable lump or something was suspicious on a recent ultrasound or mammogram, your doctor may have recommended a breast biopsy.

Is it Cancer?

While requiring a biopsy may feel scary, just because you need a breast biopsy doesn’t mean that you have breast cancer. In most cases, biopsy results aren’t cancer, but having one done is the only way you can find out for sure. 

Why are Biopsies Important?

One of the best things you can do is to be well-informed on the procedure, what to expect, and how you should prepare. We’ve put together a helpful guide to breast biopsies. And remember, you can always ask your doctor about anything you’re unsure of before the procedure.

So, just what exactly are breast biopsies anyway, and why are they so useful?…

What is a Breast Biopsy?

What is a Biopsy?

The Short Answer

A breast biopsy is a type of procedure done to remove a small sample of your breast tissue that can be sent to the laboratory for testing.

The Long Answer

The biopsy provides a sample of the breast tissue that doctors can use to identify and diagnose any abnormalities in the tissue that makes up lumps, thickening tissue, or concerning findings from an ultrasound or mammogram. This lab report can be used to decide whether you may require additional treatment. 

Different Types of Breast Biopsies 

Several different kinds of breast biopsy procedures exist, and the type you have will depend on the size and location of the area of concern or a breast lump. Common types of breast biopsies include: 

  • Core Needle Biopsy – A large needled is used, but no cut is required. 
  • Fine Needle Aspiration Biopsy – A very fine needle is used to take a sample of tissue or fluid without the need for a cut. 
  • Open Biopsy – A surgical procedure that involves a cut in the breast. 
  • Stereotactic Biopsy – A 3D image of your breast is used, and that’s used to guide the biopsy needed to the correct site of the area of concern or lump.
  • Ultrasound-guided Biopsy – Ultrasound images of a mass or lump are used to help guide a needled to the correct site of the biopsy.
  • Vacuum-assisted Core Biopsy – This involves a small cut through which a probe or hollow tube is inserted and then guided to the mass or breast lump via ultrasound, X-rays, or MRI. Then the tissue is pulled into the probe and cut from the breast. This may be used to acquire multiple samples at once. 

How Do You Decide Which Biopsy is Best for You?

The type of breast biopsy recommended for you will be determined by several things, such as: 

  • If there is more than one area that needs to be biopsied 
  • Your own preferences
  • How suspicious the change in the breast seems to be
  • Where the lump or mass is located within the breast
  • Additional medical issues you may have
  • The size of the mass or lump 

Usually, a needle biopsy can be done to address the most suspicious areas. However, talk to your physician about the type of biopsy you’ll have and what you should expect. 

So, why exactly would someone need a biopsy in the first place?…

Why Would Someone Need a Biopsy? 

Your physician may recommend that you have a breast biopsy for various reasons, including: 

  • A mammogram has shown a suspicious area within the breast tissue, such as a fluid-filled cyst or a calcium deposit seen in breast tissue
  • To check out a mass or lump that can be felt within the breast during a breast exam 
  • An MRI of the breast showed suspicious findings
  • An ultrasound scan of the breast has shown concerning findings
  • You’re experiencing strange areolar or nipple changes, such as bloody discharge, crusting, dimpling of the skin, or scaling
  • To determine whether a mass or lump within the breast is cancer or not cancer 

Cancer or Something Else?

Remember, while lumps or additional areas of concern within your breast could be caused by cancer, it also could be caused by a far less serious issue. Your physician may recommend a breast biopsy for other reasons, as well. 

Trust Your Gut

If your physician doesn’t feel you should have a biopsy, but you feel there’s something wrong, trust your instincts. Discuss this with your doctor and request a biopsy if you feel it is needed or consider visiting another physician to get a second opinion. Having a breast biopsy is the only way you can definitively diagnose breast cancer. 

As with any procedure, there are some risks with breast biopsies, including…

What are the Risks of Having a Biopsy? 

As with any medical procedure, there are some risks associated with having a breast biopsy performed. Potential risks of having a breast biopsy procedure may include: 

  • Bleeding at the site of the biopsy 
  • Infection at the biopsy site
  • Swelling and bruising of the breast 
  • Change in breast appearance, although this depends on the amount of tissue removed and the way your breast heals after the breast biopsy
  • Pain at the site of the biopsy

In the event your biopsy is done using an X-ray for guidance, the amount of radiation exposure is quite small. Your risk of radiation exposure-related issues is extremely low. 

When Should You Contact Your Doctor?

If you develop a fever after having a breast biopsy, the site of the biopsy becomes warm of red, or you notice unusual drainage from the site, contact your physician. These symptoms could indicate an infection that requires treatment. 

Now that you know what a biopsy is and what the risks are, you next need to know how to prepare for your upcoming biopsy…

How to Prepare for a Breast Biopsy

Your healthcare provider will explain the breast biopsy procedure to you. Be sure to ask any questions you may have. Helpful tips to remember as you prepare for your procedure include: 

  • Before your procedure, you’ll be required to sign a consent form for the breast biopsy. Be sure to read carefully before signing, asking questions if you find anything that’s unclear. 
  • Avoid using powder, lotion, deodorant, perfume, or creams on the breast, arm, and underarm the day of your breast biopsy. 
  • If you are given general anesthesia for your biopsy (usually only done for open biopsies), you’ll be asked to fast for several hours before your procedure. Be sure to discuss the specific fasting instructions with your surgeon. 
  • Let your doctor know if you’re pregnant or think it’s possible that you’re pregnant. 
  • Be sure to notify your medical providers if you have any bleeding disorders. You must also tell them if you’re taking medicines that may think the blood, such as aspirin or blood thinners. These medications may need to be discontinued for a few days before the breast biopsy.  
  • You also should notify your physician about all the medicines you take, including prescription, over-the-counter, and even supplements. 
  • If you’re sensitive or allergic to anesthesia medications, latex, tape, or other medicines, notify your healthcare professional. 
  • If general anesthesia or sedation is used, be sure you have an adult to drive you home after the procedure since you’ll be unable to drive. 
  • In the event magnetic resonance imaging (MRI) will be used to guide your biopsy, let your physician know if you have a pacemaker or other types of electronic devices implanted within your body. In these cases, MRI usually isn’t recommended. 
  • Wear a comfortable bra to your breast biopsy. It can offer support for your breast after the biopsy, and if a cold pack is placed on the site post-biopsy, it can help hold it in place. 

You’ve arrived at the doctor’s office for your biopsy. What can you expect to happen during the procedure?…

What Happens During a Biopsy? 

Your breast biopsy could be done in a physician’s office, in a surgical center, or a hospital on an outpatient basis. Depending on the type of biopsy you require, a hospital stay could be necessary. However, the procedures may vary depending on the type of biopsy done, your specific health condition, and the practices of your physician. 

Needle Breast Biopsy 

Usually, a needle biopsy will follow these steps: 

  • Step 1: You’ll remove your clothing from the waist up and put on a gown.
  • Step 2: You’ll be asked to either sit up or lie down, depending on whether ultrasound or X-ray guidance will be used and the preference of the provider. 
  • Step 3: A sterile solution will be used to clean the biopsy site.
  • Step 4: If they’re using a local anesthetic, the medicine will be injected by a needle. You may experience a brief stinging feeling from the needle and medicine entering the tissue. Your biopsy won’t begin until the area has become numb. 
  • Step 5: If ultrasound is being used, the probe will be placed on the breast to determine the exact site of the mass or lump. 
  • Step 6: If stereotactic imaging is being used, you’ll like face down, placing your breast into an opening within the table. A computer is used to find the specific area of the mass or lump. 
  • Step 7: You’ll be asked to stay still throughout the procedure. However, you won’t be required to hold your breath. 
  • Step 8: A needle will be placed directly into the biopsy site or via a very tiny incision. A sample of fluid or tissue will be removed, and when that occurs, you may feel a bit of pressure inside your breast.
  • Step 9: When the needle has been removed, pressure will be placed upon the site until all bleeding has stopped. 
  • Step 10: If required, an adhesive strip or stitch may be used to close an opening if it was needed. 
  • Step 11: Sterile dressings or bandages will be applied directly to the biopsy site. 
  • Step 12: The tissue or fluid will be sent to the lab to be evaluated. 

Of course, if you have an open breast biopsy, the following will likely occur…

Open Breast Biopsy 

If you are having an open breast biopsy, it will usually follow these steps.

  • Step 1: You’ll be provided with a gown to wear after removing all of your clothing. 
  • Step 2: An intravenous (IV) line will likely be started in your hand or arm.
  • Step 3: You’ll be placed upon an operating table. 
  • Step 4: You may be sedated, so you’re relaxed and groggy. 
  • Step 5: If your provider is giving local anesthesia, a needle will be used to deliver that anesthetic to your breast tissue, and you may feel a pinching or burning pain for just a moment. 
  • Step 6: If you are receiving general anesthesia, it will be administered by an anesthesiologist who will continually check your blood pressure, blood oxygen levels, heart rate, and breathing throughout the surgical procedure. 
  • Step 7: The skin over and around the surgical site will be cleaning using a sterile solution to sterilize the area. 
  • Step 8: A small incision will be made into the skin and the breast tissue until the mass or lump has been exposed. 
  • Step 9: The full lump or a piece of the lump will be removed. 
  • Step 10: The incision is closed using adhesive strips or stitches. 
  • Step 11: A bandage or dressing will be applied over your stitches or strips. 
  • Step 12: The tissue removed from your breast will be sent away to the lab to be examined. 

What can you expect after your biopsy is complete?…

What Happens After a Biopsy? 

Immediately After

The length of time it takes for recovery depends upon the specific type of breast biopsy that was performed, as well as the type of anesthesia your provider used.

  • If general anesthesia was used, you’ll be placed in a recovery room and watched closely. After your breathing, blood pressure, and pulse are all stable, and you become alert, you’ll be either released to go home or taken to a hospital room.
  • If your biopsy was done outpatient, then ensure someone else is there to drive you home.
  • If local anesthesia was used, then you’ll be able to go home after a short recovery period. 

Home Care 

Monitor Stitches

After you return home, ensure you keep the biopsy site dry and clean.

  • If you don’t have stitches, you’ll be allowed to remove the dressing or bandage according to your physician’s instructions. Once that’s removed, you can bathe as normal.
  • However, if you have stitches, they’ll need to be removed when you see your healthcare provider. 

Expect Soreness

Expect the site of the breast biopsy to be sore for a few days after the procedure. You can take pain relievers as recommended by your physician. Only take recommended pain medicines, since aspirin and some other medications may increase the risk of bleeding. Wearing a comfortable, supportive bra may help relieve pain and discomfort, too. 

Mind Your Diet and Exercise

In most cases, you can immediately return to your regular diet until told otherwise by your physician. You may be instructed to avoid engaging in any strenuous physical activity for several days. 

When to Call Your Healthcare Provider

If you experience any of the following symptoms, it’s critical to call your doctor: 

  • Swelling or redness around the biopsy site
  • Bleeding or any other type of drainage from the site of the breast biopsy
  • An increase in pain around the site
  • Chills or a fever

Additional instructions may be provided to you by your healthcare professional, depending on the procedure and your unique medical needs. 

What’s Next?

What’s most important to remember about having breast biopsies?…

Final Thoughts 

What Happens to Your Sample?

Once your breast biopsy is complete, the tissue is sent off to a lab where it’s examined by a pathologist – a doctor specializing in analyzing body tissue and blood.

When Can You Expect Results?

It usually takes several days for the results of the biopsy to be available. The pathologist will prepare a report and send it to your physician, who will share those results with you. 

What to Do After Receiving Results

Benign (Non-cancerous) Results

If the breast biopsy shows benign breast changes or normal results, then your physician will want to ensure that the pathologist and radiologist agree. Their opinions may differ, and if they do, more investigation may be needed. For example, if a radiologist believes that your mammogram suggests there’s a more suspicious lesion, but the biopsy showed normal breast tissue, your doctor may want to obtain more breast tissue to evaluate this area more thoroughly. 

Cancerous Results

If the pathology report notes that the biopsy sample did have breast cancer cells, that report should include information on the type of breast cancer and whether the type of cancer is hormone receptor negative or positive. With this information, you and your physician will be able to come up with a treatment plan that’s tailored to meet your specific needs. 

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