Breast Biopsy

What is Breast Biopsy

Breast biopsy is a procedure in which a sample of suspicious breast tissue is removed from your breast.

Following the procedure, the tissue or liquid that is removed from the breast is examined under a microscope to see if cancerous cells are present. You may need a breast biopsy if you have:

  • Any undiagnosed breast mass (tumor).
  • Nipple abnormalities, dimpling, crusting, or ulcerations.
  • Abnormal discharge from the nipple, especially blood.
  • Redness, swelling, and pain of the breast.
  • Calcium deposits (calcifications) or abnormalities seen on a mammogram, ultrasound results, or MRI results.
  • Suspicious changes in the breast seen on your mammogram.

If the breast abnormality is found to be cancerous (malignant), a breast biopsy can help to determine what the best treatment is for you. There are many different types of breast biopsies. Talk with your health care provider about your options and which type is best for you.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Bleeding.
  • Infection.
  • Discomfort. This is temporary.
  • Allergic reactions to medicines.
  • Bruising and swelling of the breast.
  • Alteration in the shape of the breast.
  • Damage to other tissues.
  • Not finding the lump or abnormality.
  • Needing more surgery.

What happens before the procedure?

  • Plan to have someone take you home after the procedure.
  • Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
  • Do notdrink alcohol for 24 hours before the procedure.
  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
  • Wear a good support bra to the procedure.
  • Ask your health care provider how your surgical site will be marked or identified.
  • You may be given antibiotic medicine to help prevent infection.
  • Your health care provider may perform a procedure to place a wire (needle localization) or a seed that gives off radiation (radioactive seed localization) in the breast lump. A mammogram, ultrasound, MRI, or a combination of these techniques will be done during this procedure to identify the location of the breast abnormality. The imaging technique used will depend on the type of biopsy you are having. The wire or seed will help the health care provider locate the lump when performing the biopsy, especially if the lump cannot be felt.

What happens during the procedure?

You may be given one or both of the following:

  • A medicine to numb the breast area (local anesthetic).
  • A medicine to help you relax (sedative) during the procedure.

The following are the different types of biopsies that can be performed.

Fine-Needle Aspiration

A thin needle will be attached to a syringe and inserted into a breast cyst. Fluid and cells will be removed. This technique is not as common as a core needle biopsy.

Core Needle Biopsy

A wide, hollow needle (core needle) will be inserted into a breast lump multiple times to remove tissue samples or cores.

Stereotactic Biopsy

You will lie face-down on a table. Your breast will pass through an opening in the table and will be gently compressed into a fixed position. X-ray equipment and a computer will be used to locate the breast lump. The surgeon will use this information to collect several samples of tissue using a needle collection device.

Vacuum-Assisted Biopsy

A small incision (less than ¼ inch) will be made in your breast. A biopsy device that includes a hollow needle and vacuum will be passed through the incision and into the breast tissue. The vacuum will gently draw abnormal breast tissue into the needle to remove it. No stitches (sutures) will be needed. The incision will be covered with a bandage (dressing). In this type of biopsy, a larger tissue sample is removed than in a regular core needle biopsy.

Ultrasound-Guided Core Needle Biopsy

A high-frequency ultrasound will be used to help guide the core needle to the area of the mass or abnormality. An incision will be made to insert the needle. Then tissue samples will be removed.

Surgical Biopsy

This method requires an incision in the breast to remove part or all of the suspicious tissue. After the tissue is removed, the skin over the area will be closed with sutures and covered with a dressing. There are two types of surgical biopsies:

  • Incisional biopsy. The surgeon will remove part of the breast lump.
  • Excisional biopsy. The surgeon will attempt to remove the whole breast lump or as much of it as possible.

After any of these procedures, the tissue or liquid that was removed will be examined under a microscope.

What happens after the procedure?

  • You will be taken to the recovery area. If you are doing well and have no problems, you will be allowed to go home.
  • You may notice bruising on your breast. This is normal.
  • You may have a pressure dressing applied on your breast for 24–48 hours. A pressure dressing is a bandage that is wrapped tightly around the chest to stop fluid from collecting underneath tissues. You may also be advised to wear a supportive bra during this time.
  • Do notdrive for 24 hours if you received a sedative.

Care After Breast Biopsy

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your doctor.
  • Do notdrive for 24 hours if you received a sedative.
  • Do notdrink alcohol while taking pain medicine.
  • Do notdrive or use heavy machinery while taking prescription pain medicine.

Biopsy Site Care

  • Follow instructions from your doctor about how to take care of your cut from surgery (incision) or puncture area. Make sure you:
    • Wash your hands with soap and water before you change your bandage. If you cannot use soap and water, use hand sanitizer.
    • Change any bandages (dressings) as told by your doctor.
    • Leave any stitches (sutures), skin glue, or skin tape (adhesive) strips in place. They may need to stay in place for 2 weeks or longer. If tape strips get loose and curl up, you may trim the loose edges. Do notremove tape strips completely unless your doctor says it is okay.
  • If you have stitches, keep them dry when you take a bath or a shower.
  • Check your cut or puncture area every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • More fluid or blood.
    • Warmth.
    • Pus or a bad smell.
  • Protect the biopsy area. Do notlet the area get bumped.

Activity

  • Avoid activities that could pull the biopsy site open.
    • Avoid stretching.
    • Avoid reaching.
    • Avoid exercise.
    • Avoid sports.
    • Avoid lifting anything that is heavier than 3 pounds (1.4 kg).
  • Return to your normal activities as told by your doctor. Ask your doctor what activities are safe for you.

General instructions

  • Continue your normal diet.
  • Wear a good support bra for as long as told by your doctor.
  • Get checked for extra fluid in your body (lymphedema) as often as told by your doctor.
  • Keep all follow-up visits as told by your doctor. This is important.

Contact a health care provider if:

  • You have more redness, swelling, or pain at the biopsy site.
  • You have more fluid or blood coming from your biopsy site.
  • Your biopsy site feels warm to the touch.
  • You have pus or a bad smell coming from the biopsy site.
  • Your biopsy site breaks open after the stitches, staples, or skin tape strips have been removed.
  • You have a rash.
  • You have a fever.

Get help right away if:

  • You have more bleeding (more than a small spot) from the biopsy site.
  • You have trouble breathing.
  • You have red streaks around the biopsy site.
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