What is a breast biopsy?
A breast biopsy is a minimally invasive needle procedure performed by a specialized radiologist with image guidance and a local anesthetic to remove a small sample of your breast tissue. After the tissue is removed, it’s passed on to a pathologist, who studies the sample to determine whether cancer cells are present. If cancer is detected, a biopsy helps determine what kind of cancer it is and how to treat it.
At Penn Medicine, breast biopsies are performed using advanced image-guided technology by radiologists who specialize in breast imaging. Every biopsy is reviewed by a breast pathologist, combining specialized expertise with detailed analysis to help guide treatment decisions. We’re also home to several American College of Radiology-designated Comprehensive Breast Imaging Centers of Excellence.
Who is a candidate for a breast biopsy?
How to prepare for a breast biopsy procedure
Usually, limited preparation is needed for a breast biopsy. You should tell your radiologist about any medications you are taking and bring any results from recent breast imaging (mammograms or ultrasounds) to be reviewed before the procedure. The breast radiology team will give you specific instructions on how to prepare for your biopsy, based on which procedure you will have.
Is anesthesia used during a breast biopsy?
We always use local anesthesia for image-guided needle biopsies and aspirations. For surgical biopsies, most people require general anesthesia. Breast biopsies are most often performed as an outpatient procedure.
What breast biopsy types are used?
We use mammography, ultrasound and MRI to target abnormal tissue and collect samples from the breast. The type of biopsy we use depends on factors including the location, appearance, and size of the abnormal tissue. It also depends on individual patient needs and abilities. Our breast cancer team always performs the least invasive procedure possible that is best for the patient.
During this minimally invasive procedure, the radiologist uses a hollow needle to remove a small amount of tissue. After numbing the breast with local anesthesia, we insert the biopsy needle into the suspicious area. To locate the mass, we may guide the CNB with advanced imaging, including:
- Ultrasound, which uses sound waves to create images of the breast
- MRI (magnetic resonance imaging), which creates images of breast tissue using a magnet and radio waves
- Mammography, which uses X-rays to create images of the breast
Typically, the doctor will place a small marker (also called a clip) into the biopsy target area. The clip marks the location for future imaging and procedures. You'll require no stitches after a CNB and can return to normal activity in a day or two. You can eat and drink before the procedure. You can drive yourself to the procedure.
Depending on the imaging appearance and your signs or symptoms, we may perform a fine needle aspiration instead of a core needle biopsy. We may use FNA to sample cysts or enlarged lymph nodes.
During this minimally invasive procedure, we inject local anesthetic and then use a thin needle and syringe to collect fluid or cells from the suspicious area. The needle is the same size as the needle used to draw blood. You can eat or drink before the procedure. You can drive and return to work immediately afterward.
A sentinel lymph node biopsy is a surgical procedure performed in the operating room by a surgeon under general anesthesia. It is typically performed after a breast cancer diagnosis is confirmed. For invasive breast cancers, like invasive ductal carcinoma and invasive lobular carcinoma, we use this type of biopsy to check for the spread of cancer. This information helps us with breast cancer staging.
Our surgeon identifies the sentinel lymph nodes using dye or a radioactive substance and removes them to examine for cancer cells. If we find cancer cells in a sentinel lymph node, specialized techniques will be used to treat it.
We perform a surgical biopsy to remove more tissue than can be removed with a needle. Our surgeons perform excisional and incisional biopsies in a hospital operating room. After we numb the area with local anesthesia, we make an incision and remove abnormal tissue using the least invasive techniques possible. These procedures may leave a scar and will require more recovery time than nonsurgical biopsy methods.
Our surgeons perform two distinct types of surgical biopsies:
- Excisional biopsy: We remove the whole abnormal area and some surrounding tissue, similar to a lumpectomy.
- Incisional biopsy: We remove only part of the abnormality. This type of biopsy is not as common as an excisional biopsy.
To help locate the precise area for the surgeon to remove during the biopsy, we may mark the spot with a specialized device. The surgeon can use state-of-the-art technology to find the device in the operating room. The breast radiologist uses local anesthetic and techniques similar to biopsy, to target and place the device days to weeks prior to the operation.
How long do biopsy results take?
After extraction of the tissue, the breast biopsy sample is kept at Penn Medicine to be analyzed by a specialized pathologist. The tissue must process overnight before it can be examined. After the pathologist reaches a decision, the report of the findings is available to your physician and the radiologist, who will then communicate the results to you. Because of this course of action, breast biopsy results typically take 2-3 working days to reach the patient but may take up to a week or longer depending on the complexity of the case and the tissue sample.
The report will show whether cancer cells were found in your breast. If cancer cells are found, we will be with you every step of the way. The pathology report will help you and your breast cancer team make informed decisions about next steps and breast cancer treatment. You will likely be referred for further testing to determine the stage of the cancer, which will help us create a treatment plan that is best for you.
If the report shows that the cells in a lump are benign or noncancerous, you still might require follow-up treatment as recommended by the radiologist, a surgeon, or your doctor.
Expert breast biopsy results you can trust
Our breast cancer team of coordinators, technologists, sonographers, nurses, radiologists, and pathologists use advanced imaging and technology to perform breast biopsies. We offer compassionate care and work quickly to get you the answers you need. At Penn Medicine, you’ll find:
- Skilled radiologists: Our specialized radiologists diagnose patients using core biopsy. Biopsy results take 2-3 working days and eliminate the need for most excisional (surgical) biopsies. Core biopsy is quick, minimally invasive, and provides our breast cancer team with vital information before any surgical procedure or other treatment.
- Advanced technology: We use state-of-the-art image-guided methods and devices to precisely pinpoint abnormal breast tissue.
- Dedicated pathologists: Every biopsy is evaluated by a specialized breast pathologist who only works with breast tissue. Our extensive experience means your tissue is in the hands of experts who catch details others might miss. The breast cancer diagnosis we deliver is in-depth and accurate.
- Specialized care close to home: We conduct breast biopsies at all Penn Medicine breast cancer locations. You have access to our team of providers and breast pathologists no matter where you live.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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