Breast Biopsy

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