Lumps or other abnormalities in your breast may be found by physical examination, mammography, ultrasound, or another type of imaging exam. But it’s not always possible to tell from an image or physical examination whether a growth is harmless or could potentially threaten your health. In such cases, a biopsy or aspiration may be recommended.
How Biopsies & Aspirations Work
With a breast biopsy, tiny samples of the lump are removed and examined to determine whether it may be cancerous. Most biopsies prove benign (non-cancerous). Biopsies are usually performed using a hollow needle with imaging guidance. The tissue is examined under a microscope by a pathologist to determine a diagnosis.
Aspiration is recommended when it is thought that a lump may be a cyst, which is a fluid-filled sac. To be certain the lump is a cyst, your radiologist may use a fine needle to puncture the lump and remove the fluid, which usually causes the cyst to collapse and disappear. Rest assured, removing small samples from the breast for diagnosis is now a safe, accurate procedure that usually involves only minimal discomfort and is extremely well tolerated by patients.
Why Physicians Use Breast Biopsy
Breast images may not be conclusive. Your physician may need a small breast sample (biopsy) to accurately tell you whether a finding in a breast image is harmless or not. Identification of lumps and other suspicious sites as early as possible provides women with the best chance to preserve long-term health. Suspicious findings in the breast usually require biopsy for diagnosis. If biopsy is needed, we at the Baystate Breast & Wellness Center will work with you to schedule the procedure as quickly as possible. You can put your worries to rest if the biopsy results are benign (non-cancerous), which is 60-80% of the time. If the biopsy shows a malignant or high-risk (atypical) result, we will work with you to coordinate a referral to a breast surgeon.
Preparing for Your Breast Biopsy
- Your preparation can vary, depending on the type of procedure.
- You may eat and drink a light meal beforehand.
- You may be asked to wear a gown.
- Blood thinners should be avoided for at least 3 days prior to the procedure.
- You should notify us of any allergies to local anesthetic, medications, adhesive tape, or latex.
- You may want to have a relative or friend accompany you and drive you home.
Before the procedure, our team will provide you with additional details and answer any questions you may have.
What to Expect during the Exam
You will be awake during the biopsy and should have little or no discomfort. Most women report little or no pain and no scarring.
For stereotactic (mammogram guided) biopsy:
- You will lie face down on a moveable exam table. Our technologist will position the affected breast or breasts into openings in the table.
- Your breast will be gently pressed between two compression plates.
- Using computer software, the radiologist will find the precise location of the problem area to guide accurate needle placement.
- The breast will be thoroughly cleansed and local anesthetic will be injected.
- The radiologist then makes a very small nick in the skin at the site where the biopsy needle will enter.
- The radiologist inserts the needle, advances it to the problem area, and verifies the position.
- Tissue samples are then removed.
For ultrasound guided biopsies:
- You will lie face up on an exam table in the ultrasound suite.
- Samples will be taken in a similar way to the stereotactic method described above, except that ultrasound will be used continuously during the procedure to place the needle and guide the biopsy.
With either type of biopsy, a tiny clip may be placed into the breast after the procedure to make the abnormality easier to find if the results show that surgery is needed. Let the radiologist know if you are uncomfortable during the procedure and more anesthetic will be given.
Most biopsy procedures take about 45 minutes. We will give you detailed post-biopsy care instructions. You should avoid hard physical activity for 24 hours after returning home. Then you should be able to resume all of your normal activities. The biopsy results will be available to you in less than one week.
Benefits & Risks
Your physician recommends a biopsy when a finding has an appearance that could possibly be cancerous. As medical procedures go, a biopsy or aspiration is minor. You will have little or no scarring. The speed, accuracy, and safety of breast biopsies and aspirations are considered extremely high.
Whenever your skin is penetrated, you have some risk of bleeding, hematoma (bruise) formation, or infection. After a breast biopsy, the chance of complications is extremely low.
Before a biopsy, it is normal for you to feel some anxiety or stress. We will help. We’ll give you detailed information before, during, and after the biopsy, and will make every effort to keep you comfortable and informed throughout the process.
Occasionally, breast biopsy does not provide enough tissue to make a conclusive diagnosis or will underestimate the extent of the disease. Also, some biopsies will show suspicious or atypical findings that are not cancerous themselves, but can occasionally be associated with cancer. If your diagnosis remains uncertain after a technically successful procedure, your physician may recommend surgical biopsy.