Surgical Breast Biopsy
If other tests show you might have breast cancer, your doctor may refer you for a surgical (open) breast 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.
In most cases, breast cancer can be diagnosed by a needle biopsy. Rarely, surgery is needed to remove all or part of the lump so it can be checked to see if there are cancer cells in it. This may be called an open biopsy or a surgical biopsy.
What is a surgical biopsy?
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, it depends on the reason for the excisional 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 or an 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, a mammogram or MRI 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 part of the breast to be removed.
What should you expect if you have a surgical biopsy
During a surgical biopsy
In rare cases, a surgical biopsy can be done in the doctor's office. But it’s most often done in a hospital’s outpatient department under 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). You may also have this type of biopsy done under general anesthesia (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 tissue. You often need stitches after a surgical biopsy, and the area is covered with a sterile dressing. Pressure may be applied for a short time to help limit bleeding.
After a surgical biopsy
Your doctor 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. The more tissue removed, the more likely you’ll notice a change in the shape of your breast.
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.
Radiological Society of North America, Inc. Magnetic Resonancs (MRI)-Guided Breast Biopsy. June 11, 2015. Accessed at http://www.radiologyinfo.org/en/info.cfm?pg=breastbimr on June 1, 2016.
Last Medical Review: June 1, 2016 Last Revised: August 18, 2016