Breast Biopsy

Why is a breast biopsy done?

A breast biopsy helps confirm if patients have breast cancer. It is done when a mammogram or another imaging test, or a physical exam, finds a breast change (or abnormality) that could be cancer.

What is a breast biopsy?

During a breast biopsy, a sample of cells or tissue from the area of concern is taken and examined under a microscope by a specialized doctor called a pathologist. Most breast biopsies are done using a needle, guided by imaging.

Hillsborough Radiology offers two types of breast biopsy:

Core needle biopsy

The doctor uses a hollow needle to remove a small core of tissue (about 1/16-to 1/8-inch in diameter and 1/2-inch long) from the area of concern. Usually, the doctor removes several cores.

Vacuum-assisted biopsy

The doctor uses a suction device that pulls tissue into a hollow needle. More tissue can be removed with this type of biopsy than with a core needle biopsy. Usually, the doctor removes several samples.

The imaging can be mammogram, MRI, or ultrasound as an outpatient procedure. The patient’s primary care doctor will decide which type of biopsy is best.

This depends on:

  • The size, location, and other characteristics of the breast abnormality(ies)
  • The number of abnormalities
  • Your other medical problems
  • Your personal preferences

Occasionally, a surgical biopsy to remove a larger sample is needed to diagnose breast cancer. This is usually done at a hospital.

How to prepare for a breast biopsy

Before the breast biopsy

Seven days before the breast biopsy, stop taking the following:

  • Vitamin E
  • Aspirin
  • Over-the- counter medicines containing aspirin, Motrin, and Advil
  • You can take Tylenol

If on aspirin therapy or a blood thinner (e.g., Coumadin):

  • Patients should check with their primary care doctor before stopping this medication. If patients are on Coumadin, they’ll need lab work (INR and PT) 1-2 days before the biopsy.
  • Patients should call their doctor if they have any questions about their current prescription and over-the-counter medicines.

On the day of the breast biopsy:

  • Don’t wear deodorant, powder, lotion, or perfume under your arms or on your breasts
  • Don’t wear jewelry
  • Wear a comfortable sports bra for support after the biopsy
  • Wear a two-piece outfit may be more comfortable

What to expect during the test

All types of breast biopsy:

  • Patients will be awake and should have little discomfort
  • A specially trained breast radiologist will perform the biopsy
  • After the biopsy, the radiologist will put a dressing on the area
  • No stitches are needed
  • Radiologist will send the samples to a lab for analysis

What to expect for each type of breast biopsy

Fine needle aspiration biopsy:

  • Local anesthetic will numb the area of the breast to be biopsied
  • Patients will lie on a table
  • Ultrasound images will be taken to guide precise placement of the fine needle and removal of the samples
  • The radiologist will use the fine needle to draw out fluid or small pieces of tissue

MRI guided vacuum-assisted biopsy:

  • Patients will lie face down on a moveable exam table and their breast or breasts will be positioned into openings in the table for approximately 30-60 minutes
  • Local anesthetic will numb the area of the breast to be biopsied
  • A technologist will insert an intravenous line into a vein in the patient’s hand or arm to inject contrast (dye) to better show the area of concern
  • The breast will be compressed between two compression plates and images will be taken to precisely guide placement of the needle
  • MRI images will be taken to precisely guide the placement of the suction (or vacuum-assisted) device and the needle and removal of the samples
  • The radiologist will make a small incision – less than 1/4-inch – into the breast
  • The radiologist will insert the needle and use the suction device to pull the tissue samples through the needle
  • The suction device will collect more tissue than a core-needle biopsy
  • The radiologist will remove several samples

Ultrasound-guided core needle biopsy:

  • Patients will lie on a table face up or turned slightly to the side
  • Local anesthetic will numb the area of the breast to be biopsied
  • Ultrasound images will be taken to precisely guide placement of the needle and removal of the samples
  • The radiologist will make a small incision – about 1/4-inch long – into the breast
  • The radiologist will insert the needle and remove three to six samples

On the day of the biopsy

  • Put an ice pack on the biopsy site for 30 minutes of every hour until bedtime
  • Take Tylenol as needed every 4-6 hours for pain
  • Wear a sports bra
  • For five days after the biopsy, do not take aspirin or any medicines that contain aspirin (such as Motrin or Advil)

The next day:

  • Patients can return to your normal activities, including work
  • Remove the dressing
  • Do not remove the steri-strips (thin tape), which will fall off on their own
  • If the tape doesn’t fall off after seven days, patients can take it off