For many years, a one-step procedure was the only choice. Today, most women and their health care team prefer to schedule further surgery, if needed, after the biopsy (the two-step procedure). Many studies have shown that breast cancer is easier to bear emotionally if the biopsy and treatment are done at different times.
The one-step procedure
If your biopsy results show cancer and you need to have more surgery to remove it, the surgery is almost always done later, after the biopsy. This is called a two-step procedure. But sometimes a one-step procedure can be done in which the biopsy and surgery are done during the same operation. If you are going to have a one-step procedure, you will want to know all of your treatment options beforehand because you must make important choices before the one-step procedure begins.
The two-step procedure
In the two-step approach, the biopsy is most often done on an outpatient basis. Local anesthesia is used (the breast is numbed), so you stay awake. Many women choose local anesthesia plus a sedative (medicine to make you relax) given through a vein. The sedative helps make you feel sleepy and calms any nervous or anxious feelings you may have during the procedure. The biopsy can take about an hour. You can go home an hour or so later, when the sedative wears off, but you will need someone to drive.
With the two-step procedure, if the diagnosis is breast cancer, you usually don't have to decide on treatment right away. With most breast cancers, there is no harm to your health in waiting a few weeks. This gives you time to talk about your treatment options with your doctors, family, and friends, and then decide what's best for you. (More information on treatment options is available by calling us or visiting our Web site; see the section called "Additional resources.")
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