Lumps or masses in the breast are not unusual, and most of them are not cancerous. Some breast masses can be felt during a breast exam. Others are detectable only by mammogram (breast X-ray). How a mass is detected does not determine whether it is cancerous. Breast lumps should be evaluated by a physician experienced in diagnosing breast cancer.

Typically, when a breast biopsy is recommended for an abnormal mammogram finding, a core needle biopsy is recommended as opposed to a surgical biopsy. This procedure is safe and accurate. There is minimal bleeding and minimal scarring. Patients may usually return to work and resume ordinary activities the next day.

How is image-guided core needle biopsy performed?

Core needle biopsy can be performed using ultrasonic or stereotactic guidance. Ultrasound guided biopsies are used when a solid mass is seen by ultrasound. Using sound waves, ultrasound can distinguish many benign lesions, such as fluid filled cysts, from solid lesions. Sterotactic core biopsies are used for breast calcifications or very small masses seen on mammogram.

During the procedure using stereotactic guidance, the patient lies on her abdomen on a specially designed exam table. An opening in the table allows access to the breast. The table is raised, and the biopsy is done from below the table.

The area to be biopsied is centered in the window of a specially designed compression paddle. Mammogram films are taken so the radiologist can examine the breast tissue to be biopsied.

During the procedure using ultrasonic guidance, the patient lies on her back on the exam table. The ultrasound probe is then used to identify the lump.

For either stereotactic or ultrasound guidance, a local anesthetic is used. The radiologist makes a small opening in the skin. A sterile biopsy needle is placed perpendicular to the breast tissue area to be biopsied. Computerized pictures help confirm the exact needle placement using digital imaging. Tissue samples are taken through the needle. It is common to take multiple tissue samples. This part of the biopsy takes approximately 15 to 20 minutes. Upon completion, sterile strips and a small adhesive bandage are applied to the skin. The entire procedure takes approximately an hour. Results are usually available in three to five working days.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/16/2014...#8336