After a breast exam, a mammogram or an ultrasound, your doctor may determine that a biopsy is needed to make a diagnosis. A breast biopsy removes a sample of breast tissue that is examined under a microscope to determine whether the lump is cancerous (malignant) or not (benign).
If your doctor decides you need a biopsy, you may be referred to a surgeon or another specialist who has experience performing breast biopsies. There are several different types, and the one recommended for you will depend on what was learned from earlier breast exams or breast imaging.
This procedure involves inserting a thin needle into the breast to remove cells from a lump. These cells are then examined under a microscope. Local anesthesia may be given. This test may be done to determine whether a lump is solid or is a fluid-filled cyst. A cyst will collapse and disappear after the fluid is removed. If the lump is not a cyst, another type of biopsy may be done.
For masses that are visible using ultrasound, an ultrasound-guided breast biopsy is a highly accurate method to guide a biopsy needle into a suspicious area and remove tissue for further examination by a pathologist. This procedure uses high-frequency sound waves instead of radiation. This type of biopsy is especially useful for abnormalities that show up on a mammogram or ultrasound, but can’t be felt by self-exam.
This biopsy is used to evaluate a lump that is seen on a mammogram, but cannot be felt during a breast examination. During the procedure, the patient lies on a specially designed table with an opening for the breast. If a table is used, the table is raised so that the radiologist and technologist can work underneath. A special type of X-ray precisely locates the part of the breast from where the biopsy sample is to be taken. Using local anesthesia, a needle is placed into the breast tissue to extract cells that will be sent to a pathologist to examine for cancer.
Performed under local anesthesia, this procedure involves placing a fine needle with a very thin wire into the breast at the site of a suspicious area found during a mammogram or breast ultrasound. The wire is as thin as a human hair. A second mammogram is done to make sure the needle is in the right place. Then, the patient is taken to surgery where the wire guides the surgeon to the area of breast to remove. The tissue is reviewed by a pathologist to examine for cancer cells.
In an open biopsy, the surgeon makes an incision and removes a sample of the suspicious lump or the entire lump. This is usually done on an outpatient basis, with local or general anesthetic. The tissue is then examined by a pathologist. If cancer is found, additional surgery may be necessary.
Lymphatic Mapping and SLN biopsy is a minimally invasive method to determine whether or not a cancer has spread to the lymph nodes. Prior to surgery, a radioactive dye is injected into the breast and a special gamma-camera image is taken of the lymph nodes. The surgeon will use the image to plan the incision.