Breast Biopsy
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A biopsy is a procedure to remove a small sample of breast tissue from an area that appears abnormal on an image of the breast. The abnormality may be detected on a mammogram, breast ultrasound, or breast MRI. Our pathologists can then examine the tissue to determine whether it contains cancerous cells. Radiologists always perform biopsies using a minimally invasive, non-surgical biopsy approach.
Types of Breast Biopsies
We use ultrasound, mammography, and MRI to guide breast biopsies. The type of biopsy you have will depend on which type of imaging best shows the area of concern. All biopsies are performed using local anesthesia, which numbs your breast. You will be awake without feeling any pain. The types of breast biopsy are:
Ultrasound-Guided Biopsy
We use ultrasound-guided breast biopsy when an abnormality can be well seen on ultrasound. During the biopsy we will determine the exact location of the abnormality using real-time ultrasound images and will continue to image the breast throughout the procedure.
How do I get ready for the procedure?
No special preparation is needed for an ultrasound-guided breast biopsy. Please eat normally leading up to your procedure and take your medications as usual. If you have had prior mammograms, breast ultrasounds, or breast MRIs performed at an outside office, bring these to your appointment on a CD.
What will happen during the procedure?
After you arrive and check in, you will undress from the waist up and change into a gown. One of our experienced technologists will escort you into a breast ultrasound room. The technologist and/or doctor performing the procedure (a breast radiologist) will explain the procedure, and you will have a chance to ask questions. You will lie on your back on the ultrasound table, and, if possible, we will ask you to raise your arm and place it behind your head. Together, we will find a position that is comfortable for you.
The radiologist will clean the skin of the breast with a special cleanser. He or she will use a small needle to inject a numbing medication into the breast around the area to be biopsied. Once the area is numb, the radiologist will make a tiny incision in the skin. He or she will then use the images on the ultrasound monitor to guide a special biopsy needle to the area to be biopsied. We take several samples of the area so that the pathologists (doctors who evaluate the samples) can do a thorough assessment. Once the area has been sampled, we place a biopsy marker clip to mark the area. This is extremely important so that if the area does come back as something requiring further treatment, it is marked.
This procedure usually takes about 30 minutes. Before you leave, the technologist takes two regular mammogram pictures of the breast to document the clip within the breast.
Are there any risks?
Ultrasound-guided breast biopsy has a very small risk of bleeding or infection. Some women also experience shoulder stiffness after the procedure.
After the test
When the procedure is complete, a small bandage is applied. The staff will review the post-care instructions with you. We recommend that you avoid heavy lifting or exercise and any activity that submerges the breast under water (swimming pool, bath tub) for three days. You may shower the day after the procedure.
Ultrasound-Guided Aspiration
After you arrive and check in, you will undress from the waist up and change into a gown. One of our experienced technologists will escort you into a breast ultrasound room. The technologist and/or doctor performing the procedure (a breast radiologist) will explain the procedure, and you will have a chance to ask questions. You will lie on your back on the ultrasound table, and, if possible, we will ask you to raise your arm and place it behind your head. Together, we will find a position that is comfortable for you.
The radiologist will clean the skin of the breast with a special cleanser. He or she will use a small needle to inject a numbing medication into the breast around the area to be aspirated. Once the area is numb, the radiologist will use the images on the ultrasound monitor to guide a needle to the area to be aspirated. The radiologist will remove as much fluid as possible with this needle. Depending upon the reason for the aspiration and the appearance of the fluid, the sample may be sent for additional evaluation by a pathologist or by the microbiology laboratory. If the fluid needs to be sent for pathology evaluation, we will place a biopsy marker clip at the site to mark the area. This is extremely important so that if the area does come back as something requiring further treatment, it is marked.
This procedure usually takes about 30 minutes. Before you leave, the technologist may take two regular mammogram pictures of the breast as a new baseline.
Are there any risks?
Ultrasound-guided breast aspiration has a very small risk of bleeding or infection. Some women also experience shoulder stiffness after the procedure.
After the procedure
When the procedure is complete, a small bandage is applied. The staff will review the post-care instructions with you. We recommend that you avoid heavy lifting or exercise and any activity that submerges the breast under water (swimming pool, bath tub) for one day. You may shower normally.
If your sample requires microbiology evaluation, results are generally available in one to three days. If your sample requires evaluation by a pathologist, it generally takes three to five business days before the final analysis (pathology report) is ready.
Stereotactic Biopsy
We use stereotactic (mammogram-guided) biopsy when an abnormality can be well seen with a mammogram but not well seen on an ultrasound. During a stereotactic biopsy, a mammogram machine guides the needle to the site that needs to be sampled.
How do I get ready for the procedure?
No special preparation is needed for a stereotactic breast biopsy. Please eat normally leading up to your procedure and take your medications as usual. If you have had prior mammograms, breast ultrasounds, or breast MRIs performed at an outside office, bring these to your appointment on a CD.
What will happen during the procedure?
After you arrive and check in, you will undress from the waist up and change into a gown. One of our experienced technologists will escort you into the breast biopsy room. The technologist and/or doctor performing the procedure (a breast radiologist) will explain the procedure, and you will have a chance to ask questions. During a stereotactic biopsy, you will either lie face down on a specialized table with an opening for your breast or you will sit in a chair at a specialized mammography machine. Together, we will find a position that is comfortable for you.
The technologist assisting the radiologist will carefully compress your breast and take images. A computer will use these images to determine the correct location to place the needle for the biopsy. The radiologist uses a computer console next to the biopsy unit to direct the needle to the site of the abnormality. He or she will then clean the skin of the breast with a special cleanser. A small needle will be used to inject a numbing medication into the breast around the area to be biopsied. Once the area is numb, the radiologist will make a tiny incision in the skin. He or she will then place the needle at the area to be biopsied. We take several samples of the area so that the pathologists, the doctors who evaluate the samples, can do a thorough assessment. Once the area has been sampled, we take X-rays of the samples to be sure we have the finding. At the end, we place a biopsy marker clip to mark the area. This is extremely important so that if the area does come back as something requiring further treatment, it is marked.
This procedure usually takes about 30 minutes. Before you leave, the technologist takes 2 regular mammogram pictures of the breast to document the clip within the breast.
Are there any risks?
Following breast biopsy there is a very small risk of bleeding or infection.
After the procedure
When the procedure is complete, a small bandage is applied. The staff will review the post-care instructions with you. We recommend that you avoid heavy lifting or exercise and any activity that submerges the breast under water (swimming pool, bath tub) for three days. You may shower the day after the procedure.
MRI-Guided Biopsy
We use MRI-guided breast biopsy when we detect an area of concern on MRI but not on ultrasound or mammography. During and MRI-guided biopsy, we use images generated by the MRI machine to direct our biopsy needle to the abnormality in the breast.
How do I get ready for the procedure?
No special preparation is needed for an MRI-guided biopsy. Please eat normally leading up to your procedure and take your medications as usual. If you have had prior mammograms, breast ultrasounds, or breast MRIs performed at an outside office, bring these to your appointment on a CD.
Leave your jewelry and other metal accessories at home as these are not safe to bring into the MRI scanner.
What will happen during the procedure?
After you arrive and check in, you will undress from the waist up and change into a gown. One of our experienced technologists or nurses will escort you into a consult room. A nurse will place an intravenous line (IV) so that gadolinium dye can be given. The technologist and/or doctor performing the procedure (a breast radiologist) will explain the procedure, and you will have a chance to ask questions.
The technologist will then bring you into the MRI suite and help position you on the MRI table. During an MRI-guided biopsy you will lie face down on the MRI table as you did for the initial MRI. Your breast will be gently compressed between two compression plates. We will take initial images before and after giving the gadolinium dye. Using computer software, we will measure the position of the abnormality and calculate the correct position of the needle placement. The radiologist will clean the skin with a special cleanser. A small needle will be used to inject a numbing medication into the breast around the area to be biopsied. Once the area is numb, the radiologist will make a tiny incision in the skin. He or she will then place the needle at the area to be biopsied. More MRI images will be taken to confirm the location of the needle. Once confirmed, we take several samples of the area so that the pathologists, the doctors who evaluate the samples, can do a thorough assessment.
At the end, we place a biopsy marker clip to mark the area. This is extremely important so that if the area does come back as something requiring further treatment, it is marked.
The procedure takes about one hour. Before you leave, the staff will escort you to the mammography suite. A technologist will take two regular mammogram pictures of the breast to document the clip within the breast.
Are there any risks?
Following breast biopsy there is a very small risk of bleeding or infection. The gadolinium dye that is used for the exam is extremely safe. Gadolinium dyes have been used in the United States for more than 30 years and have been given to millions of patients. A tiny amount of the dye has been found, in some cases, to stay in some parts of the body for months or years. The particular formula of gadolinium dye that we use is one that leaves the least amount of dye behind. Studies have not found any harmful effects from this retention.
After the procedure
When the procedure is complete, a small bandage is applied. The staff will review the post-care instructions with you. We recommend that you avoid heavy lifting or exercise and any activity that submerges the breast under water (swimming pool, bath tub) for three days. You may shower the day after the procedure.
Biopsy Marker Clips
Many findings that we biopsy are small and difficult or impossible to find once they have been biopsied. Biopsy marker clips are tiny metallic clips that we place at the biopsy site to mark the area in case it requires further treatment. If the area does not need further treatment, the clip will mark the area on future breast imaging exams.
Biopsy marker clips have been used for over a decade and are extremely safe. They are designed to stay in place once positioned. They are smaller than a sesame seed and are not generally something you can feel or would otherwise know is there. The clips do not set off metal detectors.
Getting Your Results
After a biopsy a pathologist will examine your tissue sample and make a final diagnosis. It generally takes three to five business days before the final tissue analysis (pathology report) is ready. You will be able to review your pathology results electronically via your patient portal. In addition, a member of our team will call you to give you the results of your biopsy in your native language or with a translator. He or she will help you understand the results and what, if any, follow-up is needed. If your results indicate that you need treatment, we will refer you to a breast surgeon and/or oncologist. Our patient navigator will coordinate those appointments for you.