A breast biopsy is a common procedure that healthcare providers use to determine if a suspicious area in your breast could be cancer, though approximately 80% of breast biopsy results are not cancer. There are many different kinds of breast biopsies. They typically involve a biopsy needle or surgery.
A breast biopsy is the only diagnostic procedure that can definitively determine if a suspicious area is cancerous.
Your healthcare provider may have you undergo a breast biopsy to confirm or rule out breast cancer or another condition. Providers usually recommend breast biopsies after other tests, such as a mammogram or a physical breast exam, when they show that there might be a chance of breast cancer.
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There are many types of breast biopsy procedures. Your healthcare provider will recommend the type that’s best for you based on certain factors, including:
The different types of breast biopsies, based on how your provider removes breast tissue, include:
The different types of breast biopsies, based on how your provider can see the concerning area, include:
Your healthcare provider may have you undergo a breast biopsy if one or more of the following situations apply to you:
Depending on the type of breast biopsy you have, a radiologist or a surgeon will most likely perform your breast biopsy.
If you’re undergoing a breast biopsy, it’s important to let your healthcare provider, surgeon and/or radiologist know:
Questions that may be helpful to ask your healthcare provider before your breast biopsy include:
If you’re getting general anesthesia for your breast biopsy, your healthcare provider may have you fast (not eat or drink) for several hours before your biopsy. You’ll want to have someone drive you home after your biopsy if you’re getting general anesthesia or a sedative because you may be groggy after the procedure.
In any situation, your provider will give you specific instructions before your breast biopsy appointment. Be sure to follow them.
Most — but not all — breast biopsy procedures involve seven general steps, including:
Here’s an explanation of how different types of breast biopsy procedures work.
If you’re undergoing a fine needle aspiration biopsy or a core needle biopsy, your healthcare provider will most likely recommend using a local anesthetic. This means that your provider will inject an anesthetic around the area of your biopsy site to numb the area so that you won’t feel pain during the procedure. You’ll also be awake during the procedure.
If you’re undergoing a surgical biopsy (excisional breast biopsy), your healthcare provider may recommend general anesthesia (you’ll be asleep, or unconscious, during the surgery) and/or local anesthesia (injection of an anesthetic near the site of your biopsy) so you won’t feel pain. They may also have you take a type of medicine called a sedative to help you relax.
Most breast biopsies involve the use of an imaging machine or material guidance method to help guide your healthcare provider to the area in your breast that they need to biopsy. If you have a lump in your breast that your provider can feel with a physical exam, they may perform a fine needle aspiration biopsy or a core needle biopsy without using an imaging machine.
During any of these imaging or guidance procedures, it’s important to be as still as possible so that your provider can accurately pinpoint the correct area of your breast.
Here’s an explanation of the different kinds of imaging or material guidance for breast biopsies.
Mammogram-guided biopsy (stereotactic biopsy): During this breast biopsy, your healthcare provider uses mammogram images, which are special X-ray images, to help find the area of your breast that they need to biopsy. Here’s what’ll happen during a mammogram-guided biopsy:
Ultrasound-guided biopsy: During this breast biopsy, your provider uses ultrasound (an imaging system that uses sound waves to make images of internal body tissues and structures) to guide them to the area of your breast that they need to biopsy. Here’s what will happen during an ultrasound-guided biopsy:
MRI-guided biopsy: During this breast biopsy, your provider uses MRI (magnetic resonance imaging), which is a machine that takes multiple detailed images without using X-rays, to guide them to the area of your breast that they need to biopsy. Here’s what’ll happen during an MRI-guided biopsy:
Wire localization (needle localization): Surgeons use wire localization for breast biopsy surgeries to help guide them to the area in your breast that they need to biopsy. Here’s what’ll happen during a wire localization procedure:
Other localizing devices: Newer methods of breast biopsy localizing devices include:
Your provider can insert any of these devices into the suspicious area of your breast the day before your breast biopsy surgery. Unlike wire localization, these devices are fully inserted into your breast and don’t stick outside of your breast. Your surgeon can then find the suspicious area in your breast by using a handheld detector during the surgery.
Once your healthcare provider has located the area of your breast that they will biopsy, they may need to make an incision (cut) on your skin to perform the biopsy.
If you’re undergoing a core needle biopsy or a vacuum-assisted core biopsy, your provider will make a small incision (cut) on your skin that’s about one-quarter of an inch in length. They will then insert the biopsy needle and/or vacuum-powered device.
If you’re undergoing a surgical biopsy, your surgeon will make a small incision into your breast that may be 1 to 2 inches and remove part or all of the suspicious lump, depending on if it’s an incisional (partial) or excisional (total) biopsy.
Fine-needle aspiration biopsies do not need an incision. Your provider will simply inject the needle into your skin to do the biopsy.
Next, your healthcare provider will remove a sample of or the entire suspicious tissue using one of the following methods:
During your breast biopsy procedure, your healthcare provider may place a very small metal marker or clip where they took the biopsy sample. Your provider may do this so that if your biopsy shows cancer cells or precancerous cells, they can locate the biopsy area to remove more breast tissue surgically.
Even if you don’t need further treatment or surgery after your biopsy, the marker allows a radiologist to see where you had your biopsy on future mammograms.
If you had a fine needle aspiration or core needle biopsy, your provider will likely use a sterile bandage to cover your biopsy site.
If you had a surgical biopsy, your surgeon will close your incision with stitches or adhesive strips. Your surgeon will give you instructions on how to care for your incision and if they will need to remove the stitches.
After your breast biopsy procedure, your healthcare provider will send your biopsy sample to a lab for examination and testing. A special scientist called a pathologist will process the sample and look at it under a microscope. They’ll determine a diagnosis, if applicable, and send the report to your provider.
There are many types of breast biopsy procedures, and each one is slightly different. Your healthcare provider will walk you through the steps of the procedure and answer any questions you have.
In general, here are some things you can expect during your breast biopsy:
If you’ve had a needle biopsy with local anesthesia, you may feel some discomfort in the biopsy area, but you’ll be able to return to your normal activities the next day.
If you’ve had a surgical biopsy, your recovery may take longer. Depending on how large your incision is and how much breast tissue your surgeon removed, it could take a couple of days to a week until you can return to your normal activities.
You’ll likely experience some pain in the biopsy area for a few days. Your surgeon will give you specific instructions for your recovery. Be sure to follow them closely.
Most breast biopsies are minimally invasive, and most people recover well from them. There are some common side effects of a breast biopsy procedure, including:
If you’re experiencing signs of an infection, such as redness, pus and/or a fever, contact your healthcare provider as soon as possible.
Very rare complications of breast biopsy procedures include:
It usually takes 1 to 2 weeks for your biopsy results to come back, but this could vary. Factors that affect how long it takes to get breast biopsy results include:
Once a pathologist has examined the biopsy tissue under a microscope, they will send the findings to your healthcare provider. Your provider will then explain and go over the results with you. They’ll also discuss if you need further testing, surgery and/or treatment.
Healthcare providers and pathologists can use many different terms on a breast biopsy report. Your healthcare provider will thoroughly explain the results to you. Don’t be afraid to ask questions.
In general, the results will reveal if the sample tissue was negative or positive for abnormal cells, pre-cancer cells and/or cancer cells.
If you had a surgical biopsy to remove a lump or tumor, the results will reveal information about the type, grade and receptor status of the tumor. It will also include information about the surrounding tissue of the tumor that your surgeon removed. This surrounding tissue is called the margin.
If your results show that you have a cancerous tumor, information about the margin shows whether the cancer is contained within the removed tissue. The terms that could be on your biopsy results concerning the tumor margin include:
If you’re experiencing signs of an infection at your biopsy site, such as persistent redness or pus, call your healthcare provider as soon as possible. You may need medical treatment.
Over one million people have breast biopsies each year in the United States. Approximately 20% of the biopsies reveal a breast cancer diagnosis.
Healthcare providers usually use a local anesthetic or general anesthetic for breast biopsies, so people who undergo a biopsy experience little discomfort.
You may feel a pinch or sting when your healthcare provider injects local anesthesia, and you’ll likely feel some pressure during the procedure, which is normal. You may have pain or discomfort after your biopsy, especially if you’ve had a surgical biopsy.
It’s important to remember that many different things can appear suspicious on a mammogram or feel suspicious upon a physical breast exam — not just cancer. Just because your healthcare provider wants you to undergo a breast biopsy doesn’t necessarily mean you have cancer, but a biopsy is the only way to know for sure.
Conditions that can look or feel similar to breast cancer include:
A note from Cleveland Clinic
Undergoing a breast biopsy can be stressful. It’s important to understand that needing to have a breast biopsy doesn’t necessarily mean you have cancer. In fact, about 80% of breast biopsies reveal that there’s no cancer. But a biopsy is the only way to know for sure. If you have questions about breast cancer screening, such as mammograms or breast biopsies, don’t be afraid to talk to your healthcare provider. They’re there to help and support you.
Last reviewed by a Cleveland Clinic medical professional on 09/23/2022.
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