Breast biopsy

Needing a biopsy does NOT mean you have cancer. What it does mean is that an area has been found on imaging or physical exam that needs closer examination. A breast biopsy is a test that removes cells or fluid so that they may be examined carefully. According to the American Cancer Society, four out of every five women in the U.S. who have breast biopsies are found not to have breast cancer. But this doesn't mean you can afford to skip your biopsy. The biopsy may reveal benign disease, tissue suggesting higher risk status, precancerous changes or breast cancer.

Not all biopsies are alike. The kind you have will depend on several things, including the size of the suspicious area, where it's located, how suspicious it appears, and your preferences.

Biopsy     Description
Fine needle aspiration   This is the simplest type of biopsy, and it's often used to evaluate a fluid filled area, such as a cyst. A radiologist will use a very thin needle and syringe to collect a small amount of tissue or cells. Cells are then examined by a pathologist under a microscope.
 
Core needle biopsy   A radiologist will use a larger needle and local anesthetic to remove more cells or tissue. The advantage of this biopsy is that more information may be obtained because more tissue is removed.
 
Stereotactic core needle biopsy   This type of biopsy may be used to sample tiny deposits of calcium or other findings seen only on a mammogram. This type of biopsy uses computerized pictures to help confirm the exact needle placement. This is a very effective way to sample very subtle and possibly very early cancers.
 
Surgical biopsy   A surgeon will remove all or part of an suspicious area. Excisional biopsy generally is a brief, straightforward surgery performed in an operating room. This procedure is also called Open Excisional biopsy and may require placement of a wire (wire guided biopsy) if the lesion is not palpable.
 
MRI biopsies   Occasionally a lesion or suspicious area is seen only on MRI (not seen on mammogram, ultrasound or examination). A radiologist will use a needle to collect samples of tissue using specialized images from the MRI to find the suspicious area.
 
Sentinel node biopsy   This is a test that is generally done once a diagnosis of cancer has been made. By placing a very small amount of radioactivity and possibly dye around the nipple, the surgeon is able to see the first nodes that drain the breast. We can then assess if any cancer has spread to these lymph nodes and if none is found, no other lymph nodes are taken. If the sentinel lymph node reveals cancer, additional lymph nodes may need to be removed.