Breast biopsies are used as the next step in your diagnosis journey if diagnostic imaging shows suspicious or abnormal discoveries. Collecting and examining breast tissue is the only way to definitively identify or rule out breast cancer. At the Abramson Cancer Center, our specialists carefully remove abnormal breast tissue and provide an expert analysis.
What Is a Breast Biopsy?
A breast biopsy is a procedure during which a small piece of your breast tissue is removed and examined for the presence of malignant cancer cells. Radiologists and/or surgeons take a small sample of breast tissue for examination, which is then passed onto a pathologist, who 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.
Your doctor will order a biopsy if a test — such as physical exam or a mammogram — shows a mass or abnormality. While this may seem scary, a mass does not necessarily signal cancer. Only about 20-25 percent of women who have a breast biopsy are diagnosed with cancer. However, breast biopsies remain crucial for confirming or denying a breast cancer diagnosis so that patients can begin treatment as early as possible.
Is Anesthesia Used During a Breast Biopsy?
Whether or not you will need anesthesia depends on the type of biopsy. For non-surgical biopsies, such as fine-needle aspiration biopsy and stereotactic core breast biopsy, we usually do not use anesthesia or local anesthesia. For surgical biopsies, we often use local anesthesia, but some patients may require general anesthesia. Breast biopsies are most often performed as an outpatient procedure.
Breast Biopsy Types
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, 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.
Surgical Biopsy
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 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 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 (FNA) Biopsy
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 surgery. For invasive breast cancers, like invasive ductal carcinoma and invasive lobular carcinoma, we use this type of biopsy to measure the spread of the cancer. This information helps us with breast cancer staging.
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).
How to Prepare for a Breast Biopsy Procedure
Usually, limited preparation is needed for a breast biopsy. You should tell your doctor about any medications you are taking and bring any results from recent breast imaging (mammograms or ultrasounds) to be reviewed before the procedure. Your care team will give you specific instructions on how to prepare for your biopsy, based on which procedure you will have.
How Long Do Biopsy Results Take?
After extraction of the tissue, the breast biopsy sample needs to be sent to the lab to be analyzed by a specialized pathologist. Afterward, the report of the findings is given to your physician, who will then communicate the results to you. Because of this course of action, breast biopsy results typically take 2-3 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, the pathology report will help you and your doctor 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 your doctor.
Breast Biopsy: Why Choose the Abramson Cancer Center
Our multidisciplinary breast cancer team uses advanced breast imaging and technology to perform breast biopsies. We offer compassionate care and work quickly to get you the answers you need. Through our Breast Cancer Program at the Abramson Cancer Center, you will 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 vital 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.
- Dedicated pathologists: Every biopsy is evaluated by a specialized breast pathologist who only works with breast tissue. Our extensive experience means we see details that may be missed. 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.
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To make an appointment, please call 800-789-7366 or request a callback.