A breast biopsy is a test used to confirm or rule out a diagnosis of breast cancer, especially when other imaging exams, such as a mammogram or breast ultrasound, show abnormal findings.
During this test, the doctor removes a small sample of tissue from inside the breast, usually from a lump, to be analyzed in a lab to check for cancer cells.
A breast biopsy can be done in the office under local anesthesia, so hospitalization is not required.
Indications for biopsy
A breast biopsy is recommended when other imaging exams, such as a mammogram, breast ultrasound, or magnetic resonance imaging (MRI), show abnormalities that could be a sign of cancer.
What is a breast biopsy?
A breast biopsy is a relatively simple procedure. During the test, the doctor:
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Applies local anesthesia to a specific area of the breast;
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Inserts a needle into the numbed area;
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Collects a small tissue sample from the lump identified in prior imaging exams;
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Removes the needle and sends the tissue sample to a laboratory for analysis.
A breast biopsy can also be performed using a vacuum-assisted device, known as a vacuum-assisted breast biopsy (sometimes referred to by brand names such as Mammotome). This procedure is guided by imaging tests such as mammography, ultrasound, or MRI, which help the doctor precisely position the needle within the lump.
In some cases, the doctor may also perform a biopsy on a lymph node, usually in the armpit (axillary region). The procedure is similar to a standard breast biopsy.
Surgical biopsy
Depending on the size of the lump, the woman’s medical history, or the type of abnormality detected on imaging, the doctor may recommend a surgical biopsy. This procedure is done in a hospital under general anesthesia and may involve complete removal of the lump.
If breast cancer is confirmed, another surgery may be necessary to examine the lymph nodes in the armpit on the same side as the affected breast. This allows the doctor to determine whether the cancer has spread to nearby lymph nodes.
Does a breast biopsy hurt?
Because local anesthesia is used, a breast biopsy generally does not cause pain. However, some pressure on the chest is normal during the procedure, which may cause mild discomfort.
Pain is typically limited to the small pricks made by the needle when the anesthesia is injected into the breast.
Care instructions
During the first 24 hours after a breast biopsy, it is recommended to avoid strenuous physical activity. However, most women can return to normal daily activities such as working, shopping, or doing light household chores.
You should contact your doctor if you notice any of the following symptoms in the first few days:
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Swelling in the breast;
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Bleeding at the biopsy site;
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Redness or warmth of the skin.
It is also common to notice a small bruise (hematoma) at the needle insertion site. To ease discomfort, the doctor may prescribe a pain reliever or anti-inflammatory medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
Interpreting the results
The results of a breast biopsy should always be reviewed by the doctor who ordered the test. The results may show:
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Absence of cancer cells: This means the breast lump is benign and not cancerous. However, the doctor may recommend continued monitoring, especially if the lump increases in size.
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Presence of cancer or tumor cells: This usually indicates cancer and provides additional details about the lump that will help guide the best treatment plan.
If the biopsy was performed surgically and the lump was removed, the report will typically include a detailed description of the lump’s characteristics.
If the lymph node biopsy result is positive, showing tumor cells, it usually means the cancer has started to spread from the breast to other areas.
How long do results take?
The results of a breast biopsy are usually available within a few days to a week. Most labs send the report to the doctor, but many electronic health systems also release the results directly to the patient’s online medical portal.