Breast Needle Biopsy

Breast needle biopsy is the removal of a sample of breast tissue using a needle. The sample is examined in a lab. This is done to examine a suspicious area in the breast. It may be done if any of the following are found:

• Lump
• Tissue thickening
• Nipple abnormality
• Discharge from the nipple
• Abnormal ultrasound or mammogram image

The biopsy can identify the area as either benign (noncancerous) or malignant (cancerous).

(You can also read about Breast Surgical Biopsy)

Complications are rare, but no procedure is completely free of risk. If you are planning to have a needle breast biopsy, your doctor will review a list of possible complications, which may include:

• Bleeding
• Infection
• Bruising

Some factors that may increase the risk of complications include:

• Obesity
• Smoking
• Poor nutrition
• Chronic illness, like diabetes
• Bleeding disorder

Be sure to discuss these risks with your doctor before the procedure.

Call your doctor if any of the following occurs after you return home:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the biopsy site
• Nausea and/or vomiting that you cannot control with the medicine you were given after surgery, or that persist for more than two days after the procedure
• Pain that you cannot control with the medicines you have been given
• Cough, shortness of breath, or chest pain
• Pain and/or swelling in your feet, calves, or legs

Prior to Procedure

Your doctor may do the following prior to the biopsy:

• Physical exam, especially a breast exam
• Blood tests
• Mammogram and/or breast ultrasound

Leading up to the biopsy:

• Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as: o Aspirin or other anti-inflammatory drugs for up to one week before surgery o Blood-thinning drugs, such as clopidogrel (Plavix) or warfarin (Coumadin)
• The night before, eat a light meal. Do not eat or drink anything after midnight if you are having general anesthesia.
• Shower the morning of the biopsy. You may be asked to use a special antibacterial soap.

Whether or not anesthesia will be used depends on the type of biopsy that you are having, for example:

• Local anesthesia—Only the area that is being operated on is numbed.
• General anesthesia —Blocks pain and keeps you asleep through the biopsy; given through an IV (needle in your vein) in your hand or arm.

Description of the Procedure

There are different breast needle biopsy techniques that your doctor can use to remove the tissue sample:

Needle Aspiration

The skin over the area will be cleaned. The doctor may inject a local anesthetic. Next, the biopsy needle will be inserted into the breast tissue. Fluid and/or tissue will be removed. The needle may be removed and re-inserted several times. This will be done to get samples from different locations. After this is done, the doctor will apply pressure to the area and cover the spot with a bandage.

Stereotactic Biopsy

Large Core Needle Biopsy or Vacuum-assisted Device Biopsy

You will be given sedation. You will also be given either general or local anesthesia. The doctor will have you lie on your stomach on a special table. The table will have an opening for your breast. X-ray images will be taken from different angles to locate the mass.

If you will have a large core needle biopsy, the doctor will insert a wire into the mass. A large needle used to remove the tissue will be threaded over this wire. A cylinder of breast tissue will be removed. If more samples are needed, the doctor may need to insert the wire and needle again to obtain them.

If you are having a vacuum-assisted device biopsy, the doctor will use pressure from a vacuum to pull tissue from the mass through a needle and into a sampling chamber. This allows the doctor to collect multiple tissue samples during one needle insertion.

The procedure usually takes between 1-3 hours. There may be slight pain in your breast after the biopsy and your doctor may prescribe pain medicine.

Post-procedure Care At Home

When you return home after the procedure, do the following to help ensure a smooth recovery:

• Take pain medicine if prescribed by your doctor
• Engage in some mind/body breathing techniques to help with any pain or discomfort.
• To relieve discomfort, apply a warm compress or a heating pad to the area.
• Wear a supportive bra.
• Be sure to follow your doctor's instructions (like, when to change bandages).

It will take about 2-5 days to receive your test results.

American Cancer Society http://www.cancer.org/

Breastcancer.org http://www.breastcancer.org

Canadian Breast Cancer Foundation http://www.cbcf.org/

Canadian Cancer Society http://www.cancer.ca

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 . St. Louis, MO: Mosby-Year Book; 1994.

Sabiston DC, Lyerly HK. Textbook of Surgery . 15th ed. Philadelphia, PA: WB Saunders Co.; 1997.