Breast Biopsy (Breast Needle Aspiration)

Physical exam, especially breast examBlood tests Mammogram and/or breast ultrasound In the days leading up to your procedure: The night before, eat a light meal and do not eat or drink anything after midnightYou may be asked to shower the morning of your procedure with a special antibacterial soap AnesthesiaMay be local for needle aspiration or general anesthesia for open biopsy Description of the Procedure Needle AspirationThe skin over the area is cleaned. A local anesthetic may be injected. The biopsy needle is inserted and fluid and/or tissue is removed. The biopsy needle may be removed and re-inserted several times to get samples from different locations. When the needle is removed for the last time, pressure is applied to the area briefly. The puncture spot is covered with a small pressure bandage. Open BiopsyYou'll be given sedation and either general or local anesthesia to numb the area. The overlying skin is cleaned. A small incision is made over the area. A sample of the tissue or the entire lump is removed. The incision is then closed with either stitches or clips, and covered with a light pressure bandage. Needle LocalizationIn some cases, the lump may be too deep within the breast to be felt by the examiner's fingers, but can be visualized by mammogram or ultrasound. A technique called "needle localization" is used. Once a mammogram, MRI, or ultrasound has located the precise location of the lump, a fine needle is placed into it. A guide wire may then be inserted through the needle into the location to be biopsied. A blue dye may be introduced as well to further guide the surgeon to the exact tissue requiring examination.

Large Core Needle BiopsyYou'll be given sedation and either general or local anesthesia to numb the area. Youll lie on your stomach on a special table that has an opening for your breast. X-ray images will be taken from different angles to help locate the lump. A wire is inserted into the lump. The large bore needle used to remove the breast tissue is threaded over the wire. A cylinder of breast tissue is removed for examination. After ProcedureThe sample is examined by a pathologist. How Long Will It Take?1-3 hours Will It Hurt?Needle aspiration and wire localization will be slightly painful during the procedure. During open biopsy, anesthesia prevents pain. Possible ComplicationsBleedingInfectionBruisingScarringTissue damageBreast deformityNumbness over area of biopsy Average Hospital StayNone Postoperative CareYou will be given pain killers, either acetaminophen, ibuprofen, or prescription medicationsWarm compresses or a heating pad may also help relieve discomfortWear a supportive braYour doctor will let you know how often to change your bandagesYou'll need to restrict exercise for 2-3 weeks after your surgery OutcomeYou'll receive test results within 2-5 days after surgery. These results will tell you if the sampled breast tissue showed any signs of cancer. Your doctor will remove your stitches within a week of your biopsy.

Call Your Doctor If Any of the Following OccursRedness, swelling, increasing pain, excessive bleeding, or discharge from the biopsy siteNausea and/or vomiting that you can't control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospitalSigns of infection, including fever and chillsCough, shortness of breath, chest pain, or severe nausea or vomitingPain and/or swelling in your feet, calves, or legs, sudden shortness of breath or chest pain RESOURCES: American Cancer Societyhttp://www.cancer.org/ Breastcancer.orghttp://www.breastcancer.org/ CANADIAN RESOURCES: Canadian Breast Cancer Foundationhttp://www.cbcf.org/ Canadian Cancer Societyhttp://www.cancer.ca/ References: Biopsy. The Breastcancer.org website. Available at: http://www.breastcancer.org/symptoms/testing/biopsy.jsp. Accessed February 19, 2008. Pfenninger JL, Fowler GC. Procedures for Primary Care Physicians. 1st ed. St. Louis, MO: Mosby-Year Book; 1994. Sabiston DC, Lyerly HK. Textbook of Surgery. 15th ed. Philadelphia, PA: WB Saunders Co.; 1997. Last reviewed March 2008 by Igor Puzanov, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.