Breast Biopsy

Biopsy, Breast

What To Think About

• Ultrasound is used to guide the placement of the needle during a fine-needle aspiration biopsy or core needle biopsy if the lump shows up on an ultrasound scan. For more information, see the medical test Breast Ultrasound.
• Some lumpiness of breast tissue is normal. The fibrous tissue in the breast often feels lumpy or bumpy, especially before your menstrual period. This lumpiness (fibrocystic changes) is so common in women that doctors now think it is a normal change. These changes usually go away after menopause, but they also may be found in women who are taking hormone replacement following menopause.
• Most breast lumps are not cancer. The chance of a breast lump being cancerous depends on whether you have gone through menopause. The risk of cancer is greater after menopause than before menopause.
• If you cannot feel the lump, the most accurate type of biopsy is an open biopsy done after a needle has been placed in the suspicious area of the breast using mammography.
• A mammogram and clinical breast examination may be needed after needle or stereotactic biopsy shows the biopsy sample is not cancer (benign). This is done to make sure that the biopsy sample was taken from the correct area. If more tissue needs to be taken, an open biopsy may be done.
• The biopsy sample may be looked at immediately. This method is called a frozen section because the sample is frozen and then sliced into very thin sections to be looked at under a microscope. Your doctor may give you the results right away. A frozen section is more likely to be done after an open biopsy. A more careful look of the biopsy is done with a permanent section to check the results of the frozen section. The results of a permanent section are available in about 3 to 5 days.
• When a breast biopsy shows that cancer is present, hormone receptor tests may be done. These tests check to see if the hormones estrogen and progesterone affect the way the cancer grows. They also may give information about the chances of the cancer returning. The results help your doctor decide whether to use hormone therapy, such as tamoxifen (Nolvadex), as part of your treatment.
• Additional tests will be done if breast cancer is found. These tests may include:
  • Flow cytometry, which checks the types of cells in the biopsy sample. This helps find cells that are growing quickly. Fast-growing cells are more likely to be cancer.
  • Tumor marker testing, which checks for the protein HER-2/neu on the cells taken during the biopsy. This marker may help your doctor choose the best medication to treat breast cancer.
• If breast cancer is found, surgery called axillary lymph node dissection may be done next to see if the cancer has spread to the lymph nodes. Axillary lymph node dissection is done by taking some or all of the lymph nodes in the armpit. Removal of the axillary lymph nodes may cause significant, long-term swelling (lymphedema) in some women.
• Sentinel node biopsy may be done instead of an axillary lymph node dissection. Sentinel node biopsy takes out less tissue, and it does not cause as many problems with lymphedema.
  • Before a sentinel node biopsy, a special test is done to find the first lymph node to which the cancer would spread. A radioactive tracer is put into the breast where the cancer is found, and a special camera takes pictures of the lymph nodes. A blue dye may also be used during a sentinel node biopsy. The first lymph node to show the tracer is called the sentinel node. A biopsy sample is then taken from this sentinel node. The dye may cause your skin to look blue or green for several days after the biopsy. It also makes your urine green for 24 hours.
  • The tissue with the sentinel nodes is taken out and looked at under a microscope for cancer. If the sentinel nodes have cancer cells, an axillary lymph node dissection also is usually done to find out how far the cancer has spread.

Go to previous section	Go to top of page	Go to next section
Author:	Maria G. Essig, MS, ELS	Last Updated: May 1, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Brent Shoji, MD - General Surgery
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.