Surgical Breast Biopsy

If other tests show you might have breast cancer, your doctor may refer you for a breast biopsy. Most often this will be a fine needle aspiration (FNA) biopsy or a core needle biopsy (CNB). But in some situations, such as if the results of a needle biopsy aren’t clear, you might need a surgical (open) biopsy. During this procedure, a doctor cuts out all or part of the lump so it can be checked for cancer cells.

What is a surgical biopsy?

For this type of biopsy, surgery is used to remove all or part of a lump so it can be checked to see if there are cancer cells in it.

There are 2 types of surgical biopsies:

  • An incisional biopsy removes only part of the abnormal area to make a diagnosis.
  • An excisional biopsy removes the entire tumor or abnormal area. An edge of normal breast tissue around the tumor may be taken, too, depending on the reason for the biopsy.

Wire localization to guide surgical biopsy

If the change in your breast can’t be felt and/or is hard to find, a mammogram, ultrasound, or MRI may be used to place a wire in the suspicious area to guide the surgeon the right spot. This is called wire localization or stereotactic wire localization.

After your breast is numbed, an imaging test is used to guide a thin, hollow needle to the abnormal area. Once the tip of the needle is in the right spot, a thin wire is put in through the center of the needle. A small hook at the end of the wire keeps it in place. The needle is then taken out. The surgeon uses the wire as a guide to the area to be removed.

What should you expect if you have a surgical biopsy?

During a surgical biopsy

Rarely, a surgical biopsy might be done in the doctor's office. But most often it's done in a hospital’s outpatient department. You are typically given local anesthesia with intravenous (IV) sedation. (This means you’re awake, but your breast is numbed, and you’re given medicine to make you drowsy.) Another option is to have the biopsy done under general anesthesia (where drugs are used to put you in a deep sleep and not feel pain).

The skin of the breast is cut to allow the doctor to remove the suspicious area. You often need stitches after a surgical biopsy, and pressure may be applied for a short time to help limit bleeding. The area is then covered with a sterile dressing.

After a surgical biopsy

Your doctor or nurse will tell you how to care for the biopsy site and what you can and can’t do while it heals. All biopsies can cause bleeding and can lead to swelling. This can make it seem like the breast is larger after the biopsy. Most often, this is nothing to worry about, and the bleeding, bruising, and swelling go away over time.

A surgical biopsy may leave a scar. You might also notice a change in the shape of your breast, depending on how much tissue is removed.

What does a surgical biopsy show?

A doctor called a pathologist will look at the biopsy tissue under a microscope to find out if there are cancer cells in it.

Ask your doctor when you can expect to get the results of your biopsy. The next steps will depend on the biopsy results.

If there are no cancer cells in the tissue, your doctor will talk to you about when you need to have your next mammogram and any other follow-up visits.

If cancer is found, the doctor will talk to you about the kinds of tests needed to learn more about the cancer and how to best treat it. You might need to see other doctors, too.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared 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. 2017. UpToDate. Accessed at www.uptodate.com/contents/breast-biopsy on September 5, 2017.

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

If other tests show you might have breast cancer, your doctor may refer you for a breast biopsy. Most often this will be a fine needle aspiration (FNA) biopsy or a core needle biopsy (CNB). But in some situations, such as if the results of a needle biopsy aren’t clear, you might need a surgical (open) biopsy. During this procedure, a doctor cuts out all or part of the lump so it can be looked at under a microscope and checked for cancer cells.

What is a surgical biopsy?

For this type of biopsy, surgery is used to remove all or part of a lump so it can be checked to see if there are cancer cells in it.

There are 2 types of surgical biopsies:

  • An incisional biopsy removes only part of the abnormal area to make a diagnosis.
  • An excisional biopsy removes the entire tumor or abnormal area. An edge of normal breast tissue around the tumor may be taken, too, depending on the reason for the biopsy.

Wire localization to guide surgical biopsy

If the change in your breast can’t be felt and/or is hard to find, a mammogram, ultrasound, or MRI may be used to place a wire in the suspicious area to guide the surgeon the right spot. This is called wire localization or stereotactic wire localization.

After your breast is numbed, an imaging test is used to guide a thin, hollow needle to the abnormal area. Once the tip of the needle is in the right spot, a thin wire is put in through the center of the needle. A small hook at the end of the wire keeps it in place. The needle is then taken out. The surgeon uses the wire as a guide to the area to be removed.

What should you expect if you have a surgical biopsy?

During a surgical biopsy

Rarely, a surgical biopsy might be done in the doctor's office. But most often it's done in a hospital’s outpatient department. You are typically given local anesthesia with intravenous (IV) sedation. (This means you’re awake, but your breast is numbed, and you’re given medicine to make you drowsy.) Another option is to have the biopsy done under general anesthesia (where drugs are used to put you in a deep sleep and not feel pain).

The skin of the breast is cut to allow the doctor to remove the suspicious area. You often need stitches after a surgical biopsy, and pressure may be applied for a short time to help limit bleeding. The area is then covered with a sterile dressing.

After a surgical biopsy

Your doctor or nurse will tell you how to care for the biopsy site and what you can and can’t do while it heals. All biopsies can cause bleeding and can lead to swelling. This can make it seem like the breast is larger after the biopsy. Most often, this is nothing to worry about, and the bleeding, bruising, and swelling go away over time.

A surgical biopsy may leave a scar. You might also notice a change in the shape of your breast, depending on how much tissue is removed.

What does a surgical biopsy show?

A doctor called a pathologist will look at the biopsy tissue under a microscope to find out if there are cancer cells in it.

Ask your doctor when you can expect to get the results of your biopsy. The next steps will depend on the biopsy results.

If there are no cancer cells in the tissue, your doctor will talk to you about when you need to have your next mammogram and any other follow-up visits.

If cancer is found, the doctor will talk to you about the kinds of tests needed to learn more about the cancer and how to best treat it. You may need to see other doctors, too.

American Cancer Society medical information is copyrighted material. For reprint requests, please contact permissionrequest@cancer.org.