Breast Biopsy Procedure: What to Expect

Learning that you have a suspicious breast mass or other atypical findings is frightening. Bedford Breast Center offers comprehensive care, support, and treatment to women experiencing the anxiety of a breast abnormality or a breast cancer diagnosis. If you have a lump in your breast that requires a biopsy procedure to accurately diagnose, here is what you should expect.

If you have found a lump in your breast – or if a mass was discovered during a mammogram or physical exam – your doctor may recommend a biopsy procedure to determine if the mass is benign or cancerous.

Getting the news that you need a breast biopsy is alarming, but it isn’t necessarily a sign that the mass is cancer or will be a health concern. Statistics from the American Cancer Society show that the majority of breast biopsies actually find non-cancerous breast conditions, and your doctor may merely require confirmation that the mass is benign.

If your doctor feels the need to perform a breast biopsy, here are answers to some of the most common questions most women have about the procedure.

What are the different types of breast biopsy procedures?

All breast biopsy procedures involve the removal of a portion of the mass and analyzing the fluid or tissue to determine whether or not it is cancerous. There are several different kinds of breast biopsies, including:

• Fine-needle aspiration biopsy
• Core needle biopsy
• Vacuum-assisted core biopsy
• Stereotactic biopsy
• Surgical biopsy

The biopsy type your doctor recommends will largely depend upon the characteristics of the mass in question.

• Fine-needle aspiration biopsy: This is generally performed on lumps that can be physically detected, as the physician will often guide the needle into the lump manually, though an ultrasound guide might also be used. In this kind of biopsy, the patient will lie flat on an examination table, and the doctor will insert a thin needle into the mass. A fine-needle aspiration biopsy is often performed when the physician suspects that the pathologist won’t require a large sample size, and if the doctor believes the mass is fluid rather than a tumor, though the needle can extract cells from a solid cyst.
• Core needle biopsy: A core needle biopsy extracts a higher volume of tissue than a fine-needle aspiration biopsy. The core needle is larger, and the procedure is typically guided with imaging equipment, either an ultrasound device or MRI, though freehand core needle biopsy might be appropriate when the lump can be felt through the skin.
• Vacuum-assisted core biopsy: A vacuum-assisted core biopsy is performed when the required tissue sample is larger than what can be extracted using either fine-needle aspiration or a standard core needle biopsy. The doctor makes a small incision into the breast and inserts a hollow probe. The probe is guided using imaging technology, and tissue is suctioned out.
• Stereotactic biopsy: A stereotactic breast biopsy is performed when a mammogram indicates the presence of calcifications that can’t be detected using ultrasound imaging. A stereotactic biopsy is either a core needle or vacuum-assisted probe biopsy guided by a mammogram. The patient will typically lie face down on a padded table with an opening for the breast. The breast will be compressed between two plates, allowing the practitioner to take X-ray images of the location of the abnormality. Once the mass is detected, the physician will make an incision into the breast, insert the needle or probe, and extract the necessary samples.
• Surgical biopsy: A surgical biopsy might also be called an open biopsy or lumpectomy. This is performed in a surgery center under general anesthesia. A surgical breast biopsy may remove a portion of the mass, or the entire lump. Surgical biopsies are usually performed when core needle biopsy samples do not yield clear results.

How painful is a breast biopsy?

Breast biopsies are not uncomfortable: in-office breast biopsies are performed with local anesthesia, patients will feel some discomfort from the local anesthesia injections. Surgical biopsies are performed with general anesthesia, there is no discomfort during the procedure. Stereotactic biopsies are accompanied by a mammogram, which involves the extended compression of the breast, which can be unpleasant.

After the biopsy is performed, pain is generally managed successfully with over-the-counter pain medications or a pain killer to take as needed for the first one to two weeks, depending on the type of biopsy.

Do breast biopsy procedures require significant recovery time?

Breast biopsy procedures are an outpatient procedure, patients can go home the same day – even after surgical biopsies. While it is recommended that patients rest for the duration of the day of the biopsy, there is no requirement that patients take off work the following day, though strenuous activities should be avoided. It is important to ask the physician if specific activities will put you at risk for complications, particularly if you have a job or lifestyle that involves heavy physical exertion.

Will my breasts look different after a breast biopsy?

Unless the physician has to remove a significant amount of tissue – if a lumpectomy is performed, for example – there is relatively little chance that the appearance of the breast will be altered. If needed, fat grafting (the removal of fat from one part of the party, transferred to the breast) can be performed to resolve any uneven or divoted areas resulting from the removal of tissue during a lumpectomy. Our doctors perform the least invasive lumpectomy possible.

When will I get the results?

Most patients can expect to receive their results in a week or less.

The medical team at Bedford Breast Center is dedicated to giving patients holistic, compassionate care. Our priority is the health, comfort, and confidence in our patients, and we strive to make every patient in our center feel heard, seen, respected, and valued.

For more information or to schedule an appointment, contact Dr. Memsic at the Bedford Breast Center. Servicing Beverly Hills, Santa Monica and the greater Los Angeles area