Breast Biopsy

A breast biopsy is often necessary to further characterize an uncertain mammogram or ultrasound finding, usually calcifications or masses. The biopsy removes a small piece of tissue that is then examined under a microscope by a pathologist to make a diagnosis.

We tend to biopsy the finding using the type of imaging we can best see the abnormality in. We can biopsy using mammogram, ultrasound or MRI. Biopsies using mammographic guidance are called “stereotactic biopsies.”

The majority (around 70%) of the biopsies we perform come back benign (NOT cancer). We are looking for the earliest possible signs of cancer and therefore biopsy many benign things to ensure they are not worrisome.

Breast biopsies are very safe. There is a low risk of bleeding and infection. Biopsies do not increase the risk of breast cancer. You typically will not scar after a biopsy.

A clip is placed at the time of the biopsy. It is a very tiny metallic device placed at the site of the biopsy. It is usually made of titanium or stainless steel and is around 3 millimeters in size. The reason it is needed is in case the biopsy comes back worrisome or cancerous, it may need to be removed and often times the only way we know where we biopsied is by using this clip as a landmark.

The visit takes around 30-60 minutes with actual procedure time taking around 5 minutes. The majority of the time is for positioning and set-up of the procedure. We will go over the consent form and talk you through the procedure beforehand. We will then position you for the biopsy. If the biopsy is under mammographic guidance, you will be sitting upright with your breast in compression like a mammogram. If the biopsy is under ultrasound guidance, you will be lying on your back (or slightly on your side) with your arm over your head. If the biopsy is under MRI guidance, you will be lying face down on a table with your breast in compression beneath the table. We will then clean the breast, identify the area that needs to be biopsied and numb up the area with lidocaine. The numbing is typically the most uncomfortable part of the procedure and should only last a few seconds. We then use a biopsy device to acquire small tissue samples. There may be a loud suction noise if we are using mammogram or MRI for the biopsy. If you are feeling sharp pain during the biopsy, we can give you more numbing if needed. The most important thing you can do during the biopsy is try not to move so we are able to precisely target the desired area. After the samples have been taken, a small metallic clip will be placed. Compression will be held for up to 5 minutes after the procedure to ensure all bleeding has stopped. Following the procedure. A two view mammogram of that breast is obtained to confirm the clip location. Before you are discharged, post-biopsy instructions will be reviewed.