Breast Biopsy (Breast Needle Aspiration)

(Breast Needle Aspiration)

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Definition

Breast biopsy is the removal of a sample of breast tissue. The removed tissue is then examined in a laboratory. A breast biopsy is done by:

Needle aspiration—a needle is inserted into a lump, and fluid and/or tissue is removed for examination
Open biopsy—an incision is made into the breast, and a piece of tissue or the entire lump is removed for examination

Needle Aspiration

Nucleus factsheet image

Parts of the Body Involved

Breast

Reasons for Procedure

A breast biopsy is done to examine a suspicious area in the breast. The biopsy can identify the area as either benign (noncancerous) or malignant (cancerous) [3]. It may be done if any of the following are found:

A lump
Tissue thickening
Calcification
Nipple abnormality
Discharge from the nipple
Abnormal ultrasound or mammogram [4] image

Risk Factors for Complications During the Procedure

Obesity [5]
Smoking
Poor nutrition [6]
Chronic illness or debilitation
Bleeding disorder
Diabetes [7]

What to Expect

Prior to Procedure

Your doctor will likely do the following:

Physical exam, especially breast exam
Blood 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 midnight
You may be asked to shower the morning of your procedure with a special antibacterial soap

Anesthesia

May be local for needle aspiration or general anesthesia [8] for open biopsy

Description of the Procedure

Needle Aspiration

The 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 Biopsy

You'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 Localization

In 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 [9], 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 Biopsy

You'll be given sedation and either general or local anesthesia to numb the area. You’ll lie on your stomach on a special table that has an opening for your breast. X-ray [10] 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 Procedure

The 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 [11].

Possible Complications

Bleeding
Infection
Bruising
Scarring
Tissue damage
Breast deformity
Numbness over area of biopsy

Average Hospital Stay

None

Postoperative Care

You will be given pain [11] killers, either acetaminophen, ibuprofen, or prescription medications
Warm compresses or a heating pad may also help relieve discomfort
Wear a supportive bra
Your doctor will let you know how often to change your bandages
You'll need to restrict exercise [12] for 2-3 weeks after your surgery

Outcome

You'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 [3]. Your doctor will remove your stitches within a week of your biopsy.

Call Your Doctor If Any of the Following Occurs

Redness, swelling, increasing pain [11], excessive bleeding, or discharge from the biopsy site
Nausea 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 hospital
Signs of infection, including fever and chills
Cough, shortness of breath, chest pain [11], or severe nausea or vomiting
Pain and/or swelling in your feet, calves, or legs, sudden shortness of breath or chest pain [11]

RESOURCES:

American Cancer Society
cancer [13].org/">http://www.cancer [14].org/

Breastcancer.org
http://www.breastcancer.org/ [15]

CANADIAN RESOURCES:

Canadian Breast Cancer Foundation
http://www.cbcf.org/ [16]

Canadian Cancer Society
cancer [13].ca">http://www.cancer [14].ca/

References:

Biopsy. The Breastcancer.org website. Available at: http://www.breastcancer.org/symptoms/testing/biopsy.jsp [17]. 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, MD [18]

Please 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 [19] 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 [20] provider prior to starting any new treatment or with any questions you may have regarding a medical [19] condition.