Breast biopsy is performed to further evaluate a breast lump that can be felt or was identified by mammogram or ultrasound and helps determine if the area of concern is cancer. There are several ways that a biopsy can be performed and the method chosen for the patient depends on how the area of concern is best identified.
A stereotactic biopsy is performed for abnormalities best seen on mammogram. It is done with a special needle through a very small skin incision. Only local anesthetic is needed, there is no need to be sedated. There is minimal pain with the procedure. The patient lies face down on a table with their breast through an opening in the table and mammograms are made. The skin will be anesthetized with a local anesthetic and a very small incision is made. Using the images and the assistance of a computer, a biopsy needle is positioned in the area of concern and biopsies are taken. The needle is then removed and a tiny metallic clip may be placed to mark the biopsy for future reference.
An ultrasound guided biopsy is performed for abnormalities best seen by ultrasound and is done with the same type of needle as a stereotactic biopsy. Instead of using a mammogram to guide the positioning of the needle, an ultrasound probe is used. The patient lies on their back and the area of concern is identified with the ultrasound. Under local anesthetic, the biopsy needle is positioned and biopsies are taken. A marking clip may be placed.
In certain cases, a needle localization procedure may be recommended. This is a two-part procedure. First, instead of going directly to the operating room, the patient visits the mammography area. A mammogram machine is used to determine the exact location of the tissue under study. A localization needle is inserted using the mammogram for guidance. When the needle is in the correct position, a small guide wire is inserted through the needle to mark the position of the abnormality and the needle is withdrawn. The wire is taped to the patient’s skin and the patient is transferred to the operating room where the surgeon uses the wire as a guide to the area in question.
After surgery, you will be taken to the recovery area where a nurse will monitor your progress. Once you are consuming fluids and feel comfortable leaving, you will be discharged. If you had an excisional biopsy under sedation, you must have someone drive you home.
Wear a bra to bed as well as during the day for the first week. Sports bras are especially comfortable for this purpose. An ice pack will help to decrease the swelling. Usually, over-the-counter medication such as Advil or Tylenol will provide sufficient relief for a needle biopsy. If you had an excisional biopsy, you may be given a prescription for a stronger painkiller. You may resume normal activities, including showering, the next day. Avoid exercise until cleared by physician. The biopsy results should be available 1 to 3 days after the procedure. Make an appointment to see your surgeon a week after the biopsy to examine the biopsy site and to discuss the biopsy results. Don not remove the Steri-Strips placed over the incision, they typically fall off after 7-10 days.
Complications of breast biopsies are not common, but can include:
- inability to biopsy the areas in question for technical reasons
- a false negative result
- complications related to anesthesia
- You have any bleeding other than a small spot on the dressing.
- You experience severe pain or swelling of the breast.
- You develop a fever over 100.4 degrees.
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