Core Needle Biopsy of the Breast

If other tests show you might have breast cancer, your doctor might refer you for a core needle biopsy (CNB). This is often the preferred type of biopsy if breast cancer is suspected, because it removes more breast tissue than a fine needle aspiration (FNA), and it doesn't require surgery.

During this procedure, the doctor uses a hollow needle to take out pieces of breast tissue from the area of concern. This can be done with the doctor feeling the area, or while using an imaging test to guide the needle.  

What is a core needle biopsy?

For a CNB, the doctor uses a hollow needle to take out pieces of breast tissue from a suspicious area the doctor has felt or has pinpointed on an imaging test. The needle may be attached to a spring-loaded tool that moves the needle in and out of the tissue quickly, or it may be attached to a suction device that helps pull breast tissue into the needle.

A small cylinder (core) of tissue is taken out in the needle. Several cores are often removed. 

illustration showing the needle insertion site of a core needle biopsy along with details of the core needle and area to be biopsied

The doctor doing the CNB may put the needle in place by feeling the lump. But usually the needle is put into the abnormal area using some type of imaging test to guide the needle into the right place. Some of the imaging tests a doctor may use include:

What should you expect if you have a CNB?

During the CNB

A CNB is an outpatient procedure most often done in the doctor’s office with local anesthesia (you’re awake but part of your breast is numbed). The procedure itself is usually quick, though it may take more time if imaging tests are needed or if one of the special types of CNB described below is used.

You may be sitting up, lying flat or on your side, or lying face down on a special table with openings for your breasts to fit into. You will have to be still while the biopsy is done.

For any type of CNB, a thin needle will be used to put in medicine to numb your skin. Then a small cut (about ¼ inch) will be made in the breast. The biopsy needle is put into the breast tissue through this cut to remove the tissue sample. You might feel pressure as the needle goes in. Again, imaging tests may be used to guide the needle to the right spot.

Typically, a tiny tissue marker (also called a clip) is put into the area where the biopsy is done. This marker shows up on mammograms or other imaging tests so the exact area can be located for further treatment (if needed) or follow up. You can’t feel or see the marker. It can stay in place during MRIs, and it will not set off metal detectors.

Once the tissue is removed, the needle is taken out. No stitches are needed. The area is covered with a sterile dressing. Pressure may be applied for a short time to help limit bleeding.

After the CNB

You might be told to limit strenuous activity for a day or so, but you should be able to go back to your usual activities after that. Your doctor or nurse will give you instructions on this.

A CNB can cause some bleeding, bruising, or swelling. This can make it seem like the breast lump is larger after the biopsy. Most often, this is nothing to worry about, and any bleeding, bruising, or swelling will go away over time. Your doctor or nurse will tell you how to care for the biopsy site and when you might need to contact them if you’re having any issues. A CNB usually doesn’t leave a scar.

Special types of core needle biopsies

Stereotactic core needle biopsy

For this procedure, a doctor uses mammogram pictures taken from different angles to pinpoint the biopsy site. A computer analyzes the x-rays of the breast and shows exactly where the needle tip needs to go in the abnormal area. This type of CNB is often used to biopsy suspicious microcalcifications (tiny calcium deposits) or small masses or other abnormal areas that can’t be seen clearly on an ultrasound.

Vacuum-assisted core biopsy

For a vacuum-assisted biopsy (VAB), a hollow probe is put through a small cut into the abnormal area of breast tissue. The doctor guides the probe into place using an imaging test. A cylinder (core) of tissue is then suctioned into the probe, and a rotating knife inside the probe cuts the tissue sample from the rest of the breast. Several samples can be taken from the same cut. This method usually removes more tissue than a standard core needle biopsy.

What does a CNB show?

A doctor called a pathologist will look at the biopsy tissue and/or fluid to find out if there are cancer cells in it. A CNB is likely to clearly show if cancer is present, but it can still miss some cancers.

Ask your doctor when you can expect to get the results of your biopsy. If the results of the CNB do not give a clear diagnosis, or your doctor still has concerns, you might need to have a second biopsy or a different type of biopsy.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Joe BN, Esserman LJ. Breast Biopsy. 2019. UpToDate. Accessed at on August 26, 2019.

Radiological Society of North America. Stereotactic Breast Biopsy. 2019. Accessed at on August 26, 2019.

Sung JS, Comstock CE. Chapter 15: Image-Guided Biopsy of Nonpalpable Breast Lesions. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2014.

Last Medical Review: September 1, 2017 Last Revised: October 9, 2017

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