Your doctor just called and said you need to have a breast biopsy, and you have no idea what to expect. How exactly are they going to remove breast tissue? Are they looking for cancer?
First, try not to panic. Nearly 75% of breast biopsies show noncancerous results.
Even so, facing a procedure like a breast biopsy can bring up a lot of questions. Jessica Fraker, M.D., and Bhavika Patel, M.D., are doctors in the Breast Clinic at Mayo Clinic in Arizona and they share their expertise on what to expect when undergoing an image-guided breast biopsy.
What is a breast biopsy?
A breast biopsy is a procedure that takes a small sample of tissue from a specific area of the breast. This is performed by a breast health specialist, most commonly a breast radiologist. Breast radiologists are doctors trained in reading and interpreting medical images.
That tissue sample is then evaluated under a microscope by a health care professional trained to examine tissue and cell samples, known as a pathologist. The pathologist will determine whether you have breast cancer.
Who needs a breast biopsy?
Biopsies are often recommended because your health care team finds something irregular in the results of your breast imaging. That imaging may be a routine screening study, like a yearly mammogram, or a scan done to evaluate a specific concern, like a breast lump.
Sometimes, breast radiologists can determine if a finding is likely not cancer — also called benign — with diagnostic images alone, so you don’t need a biopsy.
But other times, a finding is suspicious or not conclusive. Then, a breast biopsy may be recommended for a more definitive diagnosis.
What happens during a breast biopsy?
Most biopsies take place under imaging guidance, which is when breast imaging — such as a mammogram, ultrasound or magnetic resonance imaging (MRI) — is used to guide the procedure.
You will be awake for the procedure. You may need to lie or sit in a specific position to get the best pictures and biopsy sample. The area to be biopsied is cleaned and a small shot of numbing medication is used for pain control. You may experience a small pinch and a burning sensation during this part. A small incision is made and a thin needle is inserted into the breast and targeted to the concerning area. The needle is specially designed to pull out small samples of tissue.
A very small clip (like a tiny staple usually made of stainless steel or titanium) is left behind in the breast tissue at the site of the biopsy to mark the area. This allows radiologists to see the biopsy area on future breast imaging. The marker also can be used to guide a surgeon if the area needs to be removed. These clips stay fixed in place in the breast tissue and are safe with future MRIs or metal detectors. Often, you have another mammogram of the breast right after the biopsy to confirm that the clip is in the targeted area.
How painful is a breast biopsy?
It’s common to feel some mild discomfort or pressure during the procedure; however, you’ll receive numbing medication before the biopsy. Although many people anticipate that biopsy procedures will be painful, multiple studies show that average pain ratings reported are low.
What does recovery from a breast biopsy look like?
After the procedure, a health care provider places gentle pressure on the area for several minutes to help prevent bleeding. The area is bandaged and an ice pack will be applied to your breast.
It’s common to experience some discomfort, mild swelling and bruising for up to several days after the biopsy. You may feel a small ball, called a hematoma, develop over the site where a small amount of blood may collect. This is expected and will resolve over a few weeks. Your health care team gives instructions on when you can remove the bandaging and how to manage some common symptoms. The team also gives instructions on complications to watch for and signs that would warrant calling your health care team after the procedure, such as persistent bleeding or signs of infection — although these are uncommon.
How long does it take to get breast biopsy results?
It can take several days to get your results. Your health care team calls you to review the results and discuss next steps. You can expect to find out whether the tissue was cancer, what type of cells the tissue contained, and whether you need additional studies or referrals.
If the doctor is going in to take out a little suspicious tissue, why not just remove all the suspicious tissue instead?
There are a couple of reasons to biopsy rather than going straight to surgical removal. Needle biopsy usually provides accurate results with a lower overall risk of complications and cost compared with surgery. Benign biopsy results may not need any further evaluation or surgical treatment, which means you wouldn’t need to have unnecessary surgeries. Even if you do need surgery or have breast cancer, the information about the tissue from the biopsy helps guide the surgeons.
Relevant reading
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