Breast Biopsy

Introduction

A breast biopsy is a simple medical procedure in which a sample of breast tissue is removed and sent to a laboratory for testing. A breast biopsy is the best way to evaluate if a suspicious lump or portion of your breast is cancerous. When other tests show that you might have breast cancer, you will probably need to have a biopsy. Needing a breast biopsy doesn’t necessarily mean you have cancer. Most biopsy results are not cancer, but a biopsy is the only way to find out for sure. There are several conditions that can cause lumps or growths in the breast. A breast biopsy can help determine if a lump in your breast is cancerous or benign, which means noncancerous.

Before your breast biopsy, tell your doctor about any allergies you may have, especially any history of allergic reactions to anaesthesia. Also tell your doctor about any medications you may be taking, including over-the-counter drugs, like aspirin (which may cause your blood to thin) or supplements. If your doctor recommends an MRI, tell them about any electronic devices implanted in your body, like a pacemaker. Also, tell your doctor if you’re pregnant or concerned you may be pregnant.

Before the breast biopsy, your doctor will examine your breast. This could include:

  • a physical examination
  • an ultrasound
  • a mammogram
  • an MRI scan

During one of these tests, your doctor may place a thin needle or wire into the area of the lump so the surgeon can easily find it. You’ll be given local anaesthesia to numb the area around the lump.

Types of breast biopsies

There are different kinds of breast biopsies. The type you have depends on a number of things, like:

  • How suspicious the breast change looks
  • How big it is
  • Where it is in the breast
  • If there is more than one
  • Any other medical problems you might have
  • Your personal preferences
  1. Fine needle aspiration (FNA) biopsy: In an FNA biopsy, a very thin, hollow needle attached to a syringe is used to withdraw (aspirate) a small amount of tissue from a suspicious area. The needle used for an FNA biopsy is thinner than the one used for blood tests. This helps determine the difference between a liquid-filled cyst and a solid mass lump.

2. Core needle biopsy: A core needle biopsy is similar to a fine needle biopsy. A core biopsy uses a larger needle to sample breast changes felt by the doctor or seen on an ultrasound, mammogram, or MRI. This is often the preferred type of biopsy if breast cancer is suspected. 

3. Surgical biopsy: In rare cases, surgery is needed to remove all or part of the lump for testing. This is called a surgical or open biopsy. Afterwards, the sample is sent to the hospital laboratory. At the laboratory, they’ll examine the edges to ensure the entire lump was removed if it’s cancerous. A metal marker may be left in your breast to monitor the area in the future.

4. Lymph node biopsy: The doctor may also need to biopsy the lymph nodes under the arm to check them for cancer spread. This might be done at the same time as biopsy of the breast tumour, or when the breast tumour is removed at surgery. This can be done by needle biopsy, or with a sentinel lymph node biopsy and/or an axillary lymph node dissection. 

5. Stereotactic biopsy: During a stereotactic biopsy, you’ll lie face down on a table with a hole in it. The table is electrically powered, and it can be raised. In this way, your surgeon can work underneath the table while your breast is firmly placed between two plates. Your surgeon will make a small incision and remove samples with a needle or a vacuum-powered probe.

6. MRI-guided core needle biopsy: During an MRI-guided core needle biopsy, you’ll lie face down on a table with your breast in a depression on the table. An MRI machine will provide images that guide the surgeon to the lump. A small incision is made, and a sample is taken with a core needle. 

Risks of a breast biopsy

Risks associated with a breast biopsy include:

  • an altered appearance of your breast, depending on the size of the tissue removed
  • bruising of the breast
  • swelling of the breast
  • soreness at the biopsy site
  • an infection of the biopsy site

Contact your doctor if you develop a fever, if the biopsy site becomes red or warm, or if you have unusual drainage from the biopsy site. These can be signs of an infection that may require prompt treatment. 

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