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 doctor will remove cells from the suspicious area so they can be looked at 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 (cut in the skin). Each has pros and cons. The type you have depends on a number of things, like:

• How suspicious the breast change looks
• How big it is
• Where it is in the breast
• If there is more than one
• Other medical problems you might have
• Your personal preferences

Ask the doctor which type of biopsy you will have and what you can expect during and after the procedure. It’s important to ask questions if there’s anything you’re not sure about. Get a detailed list of questions to ask your doctor before getting a breast biopsy.

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, the biopsy samples will be sent to a lab where a specialized doctor called a pathologist will look at them. It typically will take at least a few days for you to find out the results.

Fine needle aspiration (FNA) biopsy

In an 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 seen on an ultrasound, mammogram, or MRI.

Surgical (open) biopsy

In rare cases, surgery is needed to remove all or part of the lump for testing. This is called a surgical or 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:

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

Lymph node biopsy

The doctor may also need to biopsy the lymph nodes under the arm to check them for cancer spread. This might be done at the same time as biopsy of the breast tumor, or when the breast tumor is removed at surgery. This is done by needle biopsy, or with a sentinel lymph node biopsy and/or an axillary lymph node dissection.