What is a Breast Biopsy?

When your physician discovers and abnormal finding in one or both of your breasts, he/she may order a breast biopsy for further evaluation. A breast biopsy can determine if the abnormality is breast cancer. This procedure removes a small sample of breast tissue for laboratory testing.

When breast lumps, unusual breast changes such as a nipple discharge, physical changes to the nipple or areola, or changes to the breast’s skin color or texture are present, there is cause for concern. In addition, even though there may not be any visible physical changes, other suspicious or concerning findings from a mammogram or ultrasound will alert your physician that a breast biopsy may be needed for further evaluation.

During the procedure, a small sample of breast tissue is removed and sent to a laboratory for pathology testing. The pathology report can help determine how your physician will proceed, and types of recommendations to offer the patient (i.e. surgery, chemotherapy, radiation.)

There are different types of biopsy procedures. The size and location of the lump or suspected abnormality will most often determine the type of procedure that is recommended.

Percutaneous Biopsy Procedures Include:

  • Fine-needle aspiration biopsy
    This procedure collects fluid and/or cell samples using a very thin needle.

  • Core needle biopsy
    Small samples of breast tissue are removed using a hollow needle.

  • Stereotactic biopsy
    A radiologist uses mammograms to locate the suspicious area(s) within the breast, then makes a very small incision where either a needle or vacuum probe will be used to collect tissues.

  • Ultrasound-guided core needle biopsy
    A radiologist uses high-frequency sound waves to produce images of the breast’s structure and suspicious area(s) within the breast, then makes a very small incision where a needle is used to collect several tissue samples for analysis.

  • MRI-guided core needle biopsy
    This procedure uses MRI guidance to generate 3D images to determine the location for the biopsy. The radiologist will make a very small incision, where a coring needle will be used to collect several tissue samples.

Surgical Biopsy Procedures Include:

  • Incisional biopsy
    This biopsy procedure is done through an incision where a portion of the breast mass is removed, then sent to the lab for analysis.

  • Excisional Biopsy
    This biopsy procedure is done through an incision where the entire breast mass is removed, then sent to the lab for analysis.

  • Wire localization
    When a lump or abnormality can be seen on imaging, but not be felt, this procedure is used to mark the location of the tissue that is to be removed during the biopsy. This is done before your actual surgery. Sometimes, it is also referred to as a needle localization or needle wire localization. You will be scheduled at a radiology facility for this procedure, just before your surgery. A radiologist will numb the breast, then insert the wire with a needle. The is used as a marker so the surgeon can locate the area in the operating room. The wire is then removed during the actual biopsy.

  • SAVI SCOUT
    This procedure uses radar for a zero-radiation way to find cancerous tumors and non-cancerous breast abnormalities. Using radar technology, the SAVI SCOUT helps breast cancer surgeons locate and remove breast tumors or other abnormalities with pinpoint accuracy (within +/- 1mm). Instead of traditional wires used with a Wire Localization procedure, a small reflector, the size of a grain of rice, is placed into the breast prior to the day of surgery. A local anesthetic is used to numb the area of the breast where the reflector is inserted through a small needle, which is done using image guidance. After it has been placed, the patient will not be able to feel it and can resume normal activity. The reflector is only activated in the operating room, and then is removed at the same time as the tumor.

Your doctor will explain which type of procedure is best for you and answer any questions you may have.