Why is a breast biopsy done?

A breast biopsy is the only way to know for sure if you have breast cancer. It is done when a mammogram or another imaging test, or a physical exam, finds a breast change (or abnormality) that could be cancer.

What is a breast biopsy?

During a breast biopsy, a sample of cells or tissue from the area of concern is taken and examined under a microscope by a specialized doctor called a pathologist.

Most breast biopsies are done using a needle, guided by imaging. The imaging shows a specially trained breast radiologist exactly where to place the needle and take the sample. The imaging can be mammogram, MRI, or ultrasound. This is an outpatient procedure.

University Radiology offers three types of breast biopsy:

Fine needle aspiration biopsy:
The doctor uses a very thin, hollow needle attached to a syringe to draw out a small amount of tissue from the area of concern. The needle is thinner than the one used for blood tests.

Core needle biopsy:
The doctor uses a large hollow needle to remove a small core of tissue (about 1/16- to 1/8-inch in diameter and 1/2-inch long) from the area of concern.
Usually, the doctor removes several cores.

Vacuum-assisted biopsy:
The doctor uses a suction device that pulls tissue into a hollow needle.
More tissue can be removed with this type of biopsy than with a core needle biopsy. Usually, the doctor removes several samples.

Types of imaging used in breast biopsies

• Mammogram (stereotactic guidance):
  • Low-dose x-rays record pictures of the breast, using a special mammogram machine
  • Used in core needle biopsy
• MRI:
  • Powerful magnets and radio waves create detailed pictures of the breast and surrounding tissue
  • Used in vacuum-assisted biopsy
• Ultrasound:
  • Sound waves look inside the breast and record pictures on film
  • Used in:
    • Fine needle aspiration biopsy
    • Core needle biopsy

Choosing the best breast biopsy

Occasionally, a surgical biopsy to remove a larger sample is needed to diagnose breast cancer. This is usually done at a hospital.

Your doctor will decide which type of biopsy is best for you. This depends on:

• The size, location, and other characteristics of the breast abnormality(ies)
• The number of abnormalities
• Your other medical problems
• Your personal preferences

How do I prepare for a breast biopsy?

• 7 days before your breast biopsy, stop taking:
  • Vitamin E
  • Aspirin
  • Over-the-counter medicines containing aspirin, Motrin, and Advil
  • You can take Tylenol
• If you are on aspirin therapy or a blood thinner (e.g., Coumadin):
  • Check with your doctor before stopping this medication
  • If you take Coumadin, you'll need lab work (INR and PT) 1-2 days before the biopsy
  • Call your doctor if you have any questions about your current prescription and over-the-counter medicines

• Don't wear deodorant, powder, lotion, or perfume under your arms or on your breasts
• Don't wear jewelry
• Wear a comfortable sports bra for support after the biopsy
• Feel free to bring a CD to listen to during the procedure (we have a CD player)
• A two-piece outfit may be more comfortable.

What should I expect during the test?

• You'll undress from the waist up and put on a gown.
• You'll be awake and should have little discomfort.
• A specially trained breast radiologist will perform your biopsy.
• After the biopsy, the radiologist will put a dressing on the area. No stitches are needed.
• We'll send the samples to a lab for analysis.

What to expect for each type of breast biopsy:

• You'll lie face down on a moveable exam table and your breast or breasts will be positioned into openings in the table.
• You'll get a local anesthetic to numb the area of the breast to be biopsied.
• Mammogram images will be taken to precisely guide placement of the needle and removal of the samples.
• The radiologist will make a small incision - about 1/4-inch long - into your breast.
• The radiologist will insert the needle and removes three to six samples.

• You may get a local anesthetic to numb the area of the breast to be biopsied, but since the needle is so thin, the injection may hurt more than the biopsy.
• You'll lie on a table.
• Ultrasound images will be taken to guide precise placement of the fine needle and removal of the samples.
• The radiologist will use the fine needle to draw out fluid or small pieces of tissue.

• You'll lie face down on a moveable exam table and your breast or breasts will be positioned into openings in the table.
• You may need to stay in this position for 30-60 minutes.
• You'll get a local anesthetic to numb the area of the breast to be biopsied.
• A nurse or technologist will insert an intravenous line into a vein in your hand or arm to inject contrast (dye) to better show the area of concern.
• Your breast will be gently compressed between two compression plates and images will be taken to precisely guide placement of the needle.
• MRI images will be taken to precisely guide the placement of the suction (or vacuum-assisted) device and the needle and removal of the samples.
• The radiologist will make a small incision - less than 1/4-inch - into your breast.
• The radiologist will insert the needle and uses the suction device to pull the tissue samples through the needle.
• The suction device collects more tissue than a core needle biopsy.
• The radiologist will remove several samples

• You'll lie on a table face up or turned slightly to the side.
• You'll get a local anesthetic to numb the area of the breast to be biopsied.
• Ultrasound images will be taken to precisely guide placement of the needle and removal of the samples.
• The radiologist will make a small incision - about 1/4-inch long - into your breast.
• The radiologist will insert the needle and removes three to six samples.

How long does a breast biopsy take?

About an hour.

What should I expect after the test?

• Bruising or discoloration
• A little oozing or droplets of blood on the dressing or skin
• Mild pain or discomfort and fullness at the biopsy site

• Put an ice pack on the biopsy site for 30 minutes of every hour until bedtime.
• Take Tylenol as needed every 4-6 hours for pain.
• Wear a sports bra.
• For 5 days after the biopsy, do not take aspirin or any medicines that contain aspirin (Motrin or Advil).

• You can go back to your normal activities, including work.
• Remove the dressing.
• Do not remove the steri-strips (thin tape), which will fall off on their own (if the tape doesn't fall off after 7 days, you can take it off).

When should I call University Radiology?

• Excessive bleeding, put firm pressure on the biopsy site for at least 20 minutes. If this doesn't stop the bleeding, call us.
• Excessive pain, discharge, redness, swelling, or warmth, call us.

Call University Radiology:

8 a.m. to 5 p.m. Monday to Friday:
Call the office where you had your procedure

Emergencies outside of normal business hours:
Call our 24/7 Call Center: 732-955-8877
Ask to speak to the radiologist or resident on call

When will I get the results?

It takes about 3-5 days to get the biopsy results from the pathology lab. We send them to your doctor right away. Your doctor will discuss the results with you.

If breast cancer is present, the report will have information about the type of breast cancer, and other information about the cancer. Your doctor will work with you to develop the best treatment plan for your needs.

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