Breast Biopsy

When other tests show that you might have breast cancer, you will probably need to have a biopsy. Needing a breast biopsy doesn’t necessarily mean you have cancer. Most biopsy results are not cancer, but a biopsy is the only way to find out. During a biopsy, a surgeon will remove cells from the suspicious area so they can be studied in the lab to see if cancer cells are present.

There are different kinds of breast biopsies. Some use a needle and some use an incision. Each has pros and cons. The type you have depends on things like how suspicious the tumor looks, how big it is, where it is in the breast, how many tumors there are, other medical problems you might have, and your personal preferences. Ask the doctor which type of biopsy you will have and what you can expect during and after the procedure.

If the doctor thinks you don’t need a biopsy, but you still feel there’s something wrong with your breast, follow your instincts. Don’t be afraid to talk to the doctor about this or go to another doctor for a second opinion. A biopsy is the only sure way to diagnose breast cancer.

Regardless of what type of biopsy you have, a doctor will need to take a tissue sample and send it to a lab where a specialist, called a pathologist, will look at it. It typically will take a few days, maybe even more than a week, for you to find out the results. Once you get them, it’s important to learn whether the results are final, or whether you need another biopsy. You may also decide that you want to get a second opinion.

Get a comprehensive list of questions to ask your doctor before getting a breast biopsy.

Fine needle aspiration biopsy

In a fine needle aspiration (FNA) biopsy, a very thin, hollow needle attached to a syringe is used to withdraw (aspirate) a small amount of tissue from a suspicious area. The needle used for an FNA biopsy is thinner than the one used for blood tests.

Core needle biopsy

A core biopsy uses a larger needle to sample breast changes felt by the doctor or pinpointed by ultrasound or mammogram. Sometimes, the biopsy needle is guided by an MRI or CT scan. Another way to do a core biopsy is known as vacuum-assisted.

Surgical (open) biopsy

In rare cases, surgery is needed to remove all or part of the lump for testing. This is called a surgical biopsy or an open biopsy. Most often, the surgeon removes the entire mass or abnormal area as well as a surrounding margin of normal- breast tissue.

There are 2 types of surgical biopsies:

• Incisional biopsy removes only part of the suspicious area, enough to make a diagnosis.
• Excisional biopsy removes the entire tumor or abnormal area, with or without trying to take out an edge of normal breast tissue (it depends on the reason for the excisional biopsy).

Lymph node biopsy

If the lymph nodes under the arm are enlarged, a doctor may need to check them for cancer spread. Most often, an enlarged lymph node is biopsied at the same time as the breast tumor.

Even if no lymph nodes are enlarged, the lymph nodes under the arm are usually checked for cancer spread when the breast tumor is removed at surgery. This is done with a sentinel lymph node biopsy and/or an axillary lymph node dissection.