Biopsy basics
If you develop a breast lump or other breast change, or if you have an abnormal finding on a mammogram, you may need to have a biopsy. A biopsy is a procedure that removes a sample of cells or tissue from the breast. The cells or tissue that have been removed are examined under a microscope to look for signs of cancer. A biopsy is generally not painful because a local anesthetic (medicine that blocks pain in the area) is used.
There are two main types of biopsies: needle biopsy
and surgical biopsy. The type of biopsy you will have depends mainly on the nature and location of
the breast abnormality and your general health and preference. Most women who have a biopsy are not diagnosed with breast cancer. Even so, you may want to bring a friend or family member with you for support and to drive you home.
Needle biopsy
Because it is fast and simple, this method is often done first. If your doctor cannot feel the lump, special equipment is used to guide the needle to the area. Fine needle aspiration (also known as FNA or fine needle biopsy) — A thin needle is used to remove cells from the breast lump. It can be done in an outpatient setting and only takes a few minutes.
Core needle biopsy — A thin, hollow needle is used to remove a small amount of tissue from the breast. It can be used on both suspicious areas that can be felt and those that can only be seen on a mammogram, breast ultrasound or MRI.
The skin is nicked with a scalpel so the needle can enter. This type of needle biopsy is done with local anesthetic in an outpatient setting. Vacuum assisted biopsy — A thicker, hollow needle removes cores of tissue with a single insertion of a vacuum assisted probe. This type of needle biopsy may be done with the guidance of stereotactic mammography or ultrasound imaging. Vacuum assisted breast biopsy is done under a local anesthetic in an outpatient setting.
Surgical biopsy
A surgical biopsy removes the abnormality from the breast. It is done in a hospital or outpatient setting with local anesthesia and sedation. Most women go home the same day.
Excisional biopsy — The entire lump plus some surrounding normal tissue are removed. This is the most common type of surgical biopsy and the most accurate way to diagnose breast cancer. Although the primary purpose is to diagnose cancer, an excisional biopsy may also be the only surgical treatment needed.
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