If diagnostic imaging is suspicious for breast cancer, the next step is a breast biopsy. Collecting and examining breast tissue is the only way to definitively identify or rule out cancer. At the Abramson Cancer Center, our specialists carefully remove abnormal breast tissue and provide an expert analysis.
What Is a Breast Biopsy?
In a breast biopsy, radiologists and surgeons take a small sample of breast tissue for examination. A pathologist studies the sample to determine whether cancer cells are present. If cancer is detected, a biopsy helps us identify any cancer spread and the stage of cancer.
Having a breast biopsy does not mean that you have cancer. Only about 20-25 percent of women who have a breast biopsy are diagnosed with cancer. Read our frequently asked questions about breast biopsy.
Breast Biopsy: Why Choose the Abramson Cancer Center
Our multidisciplinary breast cancer team uses advanced imaging and technology to perform breast biopsies. We offer compassionate care and work quickly to get you the answers you need. At the Abramson Cancer Center, you'll find:
- Skilled radiologists: Our specialized radiologists diagnose patients using core biopsy. Biopsy results take just 24 hours and eliminate the need for most excisional (surgical) biopsies. Core biopsy also provides our breast surgeons with important information before a surgical procedure.
- Advanced technology: We use innovative methods to precisely pinpoint abnormal breast tissue. Using SAVI SCOUT® radar localization technology, we remove only suspicious tissue during a biopsy.
- Expert tissue analysis: Every biopsy is evaluated by a specialized breast pathologist who only works with breast tissue. Our extensive experience means we see details that others 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 locations. You have access to our team of providers and breast pathologists no matter where you live.
Breast Biopsy Procedures We Use
We use many methods to collect tissue samples from the breast. The type of biopsy we use depends on factors including the location, appearance and size of the abnormal tissue. Our breast cancer team always performs the least invasive procedure possible.
Core Needle Biopsy (CNB)
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, also known as a stereotactic biopsy, which uses X-rays to identify abnormal tissue
Typically, the doctor will place a small marker (also called a clip) into the biopsied 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.
We perform a surgical biopsy on tissue that is difficult to reach with other types of biopsies. 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 require more recovery time than nonsurgical biopsy methods.
Our surgeons perform two different 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 tumor. This type of biopsy is not as common as an excisional biopsy.
To help locate the precise area for biopsy, we may mark the spot with a wire placed into the breast on the day of the procedure. As an alternative, we may use SAVI SCOUT® radar localization technology. It helps us place a tiny reflector on the tumor up to 30 days before a procedure.
Fine Needle Aspiration Biopsy (FNA)
If a lump or swelling is just beneath the skin, we may perform a fine needle aspiration. We commonly use FNA to examine cysts, masses or enlarged lymph nodes.
During this minimally invasive procedure, we use a thin needle and syringe to collect cells from the suspicious area. We conduct the 10-minute procedure right in the office.
Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy is typically performed after a breast cancer diagnosis is confirmed, often during breast cancer surgery. For invasive breast cancer, we use this type of biopsy to measure the spread of the cancer. This information helps us determine the stage of breast cancer.
Our surgeon identifies the lymph nodes closest to the tumor (called the sentinel lymph nodes) using dye or a radioactive substance. We surgically remove the nearest lymph nodes and examine them for cancer cells. If we find cancer cells in the sentinel lymph nodes, it means cancer has spread beyond the breast (called metastatic breast cancer).