When you or your doctor detect a breast lump, a breast biopsy is frequently recommended as it is the definitive test to rule out cancer. A biopsy removes part or all of the lump and the tissue sample is sent to pathology for examination. At least 70% of lumps biopsied are benign. Every breast mass must be evaluated by a physician, although most are not cancer.
There are three main types of breast biopsy:
1. Fine-Needle Aspiration – As its name suggests, a thin needle is used to draw tissue from the suspicious area. This biopsy is painless. In fluid filled masses, aspiration of the fluid will cause the mass to disappear completely. Fluid-filled masses such as simple cysts are never cancer.
2. Core-Needle – This is the most common type of biopsy tool because it is comfortable for the patient and a since larger sample of the lump is removed, it is more accurate than fine-needle aspiration. The procedure is performed under local anesthesia.
If you cannot feel the mass, but it was seen on imaging such as mammogram or ultrasound, the radiologist or breast surgeon may do a core biopsy under imaging guidance. Core biopsies are also done when suspicious calcifications are noted on mammogram to rule out cancer.
Note that the majority of calcifications seen on mammogram are completely benign and need not be biopsied. The procedure is quick, painless and you can resume your normal activity right away.
3. Surgery Biopsy – Another biopsy option is to remove the entire lump and is done in the operating room under general or local anesthesia, depending on the patient’s preference. This is recommended if a prior fine needle or core needle biopsy results are inconclusive.
Sometimes the pathology results don’t match with how the mass looks or feels on imaging (for example, if the pathology shows a cyst, but the imaging demonstrates a solid mass, perhaps the solid mass was missed or not sampled adequately).
The incision is tiny, placed in a hidden location (such as the armpit, areola, or the crease below the breast) and is closed with dissolvable sutures. You may have some tenderness at the incision site for a couple of days, and you can resume your regular activity in 3 to 5 days.
Remember that most lumps are benign, so don’t get concerned if your doctor recommends a biopsy. Biopsies are recommended on benign masses if they change in size, and yet they are not cancer. If it does turn out to be cancer, it is good that you are learning about it early on so that you can plan treatment with your doctor and have an excellent outcome.
Anytime you feel a lump in your breast, consult a breast specialist right away. At Bedford Breast Center, our doctors will evaluate the lump and promptly order the appropriate tests and diagnosis.