What is a breast biopsy?

Dr. Ajay K. Sahajpal, MD
Transplant Surgeon

A breast biopsy typically refers to a surgical procedure used to further work up and diagnosis a suspicious area in the breast. This is usually done with a localizing procedure or stereotactic biopsy to mark the area to be removed.

A breast biopsy is a procedure in which your doctor will numb the skin over an area of your breast where there is a lump or abnormal finding on mammogram or ultrasound. He or she will make a small cut and pass a needle into the breast tissue to obtain a sample of tissue to test for malignancy.

Dr. Stuart A. Linder, MD
Plastic Surgeon

A breast biopsy is a tissue diagnosis of the breast either by needle or by direct excision. Biopsy surgery includes FNA fine needle aspiration, True core biopsies, and direct open excisional biopsies often performed by a general surgeon in the operating room. The specimen with be sent to Pathology for specific diagnosis to rule out malignancy. In my practice, all breast tissue specimens are reviewed by Pathology department at the UCLA Medical Center for final diagnosis.

A surgical breast biopsy (often called an open breast biopsy) is a minor operation in which a short incision is made through the skin of the breast to allow the doctor to remove a small amount of breast tissue. Although many breast biopsies are done by removing a tissue sample through a needle, your doctor has determined that this surgical approach is best for your situation.

The purpose of the biopsy is to determine if the breast tissue is cancerous—not to treat breast cancer. The most common reason for a breast biopsy is because an abnormal area is found on an imaging test such as mammography or ultrasound. An abnormal physical finding such as a lump or thickened area of the breast may also indicate the need for a biopsy. The good news is that about 80 percent of breast biopsies in the U.S. show no cancer. However, it's important to check.

A breast biopsy is a way to check out breast tissue under the microscope. There are different kinds, including fine needle aspiration and core biopsy. Fine needle aspiration is usually done in the doctor’s office, and uses a very small needle to take out a few cells that are looked at under the microscope. This type of biopsy usually isn’t painful, however since only a few cells are removed, cannot always make a complete diagnosis.

A core biopsy uses a larger needle to remove a core of breast tissue that can be checked under the microscope. You are given numbing medicine prior to the core biopsy. If the mass can be felt in the doctor’s office, the core biopsy can be done immediately. It can also be done under ultrasound guidance or under mammographic guidance (called stereotactic biopsy) by the surgeon or the radiologist.

Finally, a surgical biopsy is sometimes recommended if a lesion is not amenable to biopsy under imaging guidance. Usually this is done with local anesthesia and intravenous sedation. This requires a trip to the operating room, and involves making an incision and removing the breast tissue in question for definitive diagnosis.

It is always important for the surgeon and the radiologist to make sure the biopsy results are concordant with what is seen on your imaging, to make sure that the correct area was sampled at the time of biopsy.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.