Breast Biopsy

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

The removal of a sample of breast tissue so that it can be examined in a laboratory. A breast biopsy can be done in either of two ways:

• Needle aspiration - a needle is inserted into a lump, and fluid and/or tissue is removed for examination
• Open biopsy - an incision is made into the breast, and a piece of tissue or the entire lump is removed for examination

Parts of the Body Involved

Breast

Reasons for Procedure

A breast biopsy is done to examine a questionable area in the breast and identify it as either benign (non-cancerous) or malignant (cancerous). The following are considered questionable:

• A lump
• Tissue thickening
• Calcification
• Nipple abnormality
• Discharge from the nipple
• Abnormal ultrasound or mammogram image

Risk Factors for Complications during the Procedure

• Obesity
• Smoking
• Poor nutrition
• Chronic illness or debilitation
• Bleeding disorder

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam, especially breast exam
• Blood tests
• Mammogram and/or breast ultrasound

In the days leading up to your procedure:

• Arrange for a ride to and from the procedure
• Arrange for help at home after the procedure
• The night before, eat a light meal and do not eat or drink anything after midnight
• You may be asked to shower the morning of your procedure, and you may be given special antibacterial soap to use

During Procedure - IV fluids, sedation, anesthesia

Anesthesia - Depends on the procedure; can be local anesthetic for needle aspiration or general anesthetic for open biopsy.

Description of the Procedure

Needle aspiration: The skin over the area to be biopsied is cleaned and a local anesthetic may be injected into this area. The biopsy needle is inserted into the questionable area, and fluid and/or tissue is removed for examination. The biopsy needle may be removed and re-inserted several times in order to get samples from several locations within the questionable area. When the needle is removed for the last time, pressure is applied to the area briefly, and then the puncture spot is covered with a small pressure bandage.

Open biopsy: You'll be given sedation and either general or local anesthesia to numb the area to be biopsied. The overlying skin is cleaned, and a small incision is made over the questionable area. A sample of the tissue or the entire lump is removed for examination. The incision is then closed with either stitches or clips, and covered with a light pressure bandage.

Wire localization: In some cases, the lump may be too deep within the breast to be felt by the examiner's fingers, but can be visualized by mammogram or ultrasound. In this situation, a technique called "wire localization" is used. Just prior to surgery, a special type of wire is placed into the lump using mammogram or ultrasound guidance. The surgeon uses this wire as a landmark to find the lump requiring biopsy.

After Procedure – The tissue and/or fluid sample is examined by a pathologist.

How Long Will It Take? 1-3 hours

Will It Hurt? Needle aspiration will be slightly painful during the procedure, as will wire localization of a lump. During open biopsy, anesthesia prevents pain.

Possible Complications:

• Bleeding
• Infection
• Bruising
• Scarring
• Tissue damage
• Breast deformity
• Numbness over area of biopsy

Average Hospital Stay - None

Postoperative Care:

• You'll be given pain killers, either acetaminophen, ibuprofen, or prescription medications
• Warm compresses or a heating pad may also help relieve discomfort
• Wear a supportive bra
• Your doctor will let you know how often to change your bandages
• You'll need to restrict exercise for 2-3 weeks after your surgery

Outcome

You'll receive test results within 2-5 days after surgery. These results will tell you if the sampled breast tissue showed any signs of cancer. Your doctor will remove your stitches within a week of your biopsy.

Call Your Doctor If Any of the Following Occurs

• Redness, swelling, increasing pain, excessive bleeding, or discharge from the biopsy site
• Nausea and/or vomiting that you can't control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
• Signs of infection, including fever and chills
• Cough, shortness of breath, chest pain, or severe nausea or vomiting
• Pain and/or swelling in your feet, calves, or legs, sudden shortness of breath or chest pain

SOURCES:

Procedures for Primary Care Physicians, 1st ed. Mosby-Year Book, 1994.

Textbook of Surgery, 15th ed. W. B. Saunders Co, 1997.

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Last reviewed February 2001 by Medical Review Board