Procedures & Services:
A biopsy is the removal of a sample of suspicious tissue to be examnined under a microscope. A biopsy is done when mammograms, other imaging tests, or the physical exam finds a breast change (or abnormality) that might be a cancer. A biopsy of the abnormality is the only way to determine if cancer is present.
Types of biopsies include fine needle aspiration biopsy, core (large needle) biopsy, and surgical biopsy. Which is best for you will be individualized to your case. Some of the factors your doctors will consider include how suspicious the lesion appears, how large it is, where in the breast it is located, characteristics of the abnormality, how many lesions are present, your other medical problems and your personal preferences.
A surgical biopsy or an open biopsy is usually an excisional biopsy, where the surgeon removes the entire mass or abnormal area (as opposed to an incisional biopsy, where only part of the mass is removed). In rare cases, this type of biopsy can be done in the doctor's office, but it is more commonly done in the hospital's outpatient department.
If a small lump is hard to locate by touch or if an area looks suspicious on the x-ray but cannot be felt, the surgeon may use a procedure called a stereotactic hookwire guided biopsy. After the area is numbed with local anesthetic, a hollow needle is placed into the breast, and x-ray or ultrasound views are used to guide the needle to the suspicious area. A thin wire with a bent tip has been inserted through the needle. Once the tip of the needle is in the right spot, the hollow needle is removed leaving the wire hooked in place at the abnormality . This technique guides the surgeon to successfully remove the abnormal area better than 95 percent of the time.
This type of biopsy is more involved than an FNA biopsy or a core needle biopsy, although it is more likely to result in an accurate diagnosis and, in some cases, may be the only surgery that is needed.
what TO do BEFORE SURGERY
- Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition.
- After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
- Blood transfusion and/or blood products may rarely be needed depending on your condition.
- It is recommended that you shower with an antibacterial soap the night before or morning of the operation.
- After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon and/or anesthesiologist has told you to take with a sip of water the morning of surgery.
- Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and large doses of Vitamin E will need to be stopped temporarily for several days to a week prior to surgery.
- Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
- Quit smoking and arrange for any help you may need at home.
how is a breast biopsy performed?
You will most likely be asked to check into the hospital the morning of your surgery.
- A breast biopsy is performed under a local or a general anesthesia. It usually takes less than one hour.
- A small incision is made over the palpable mass or near the localization wire.
- After the surgeon removes the intended part of the breast, the small incision is closed.
what should i expect after surgery?
Our goal is for your surgery and recovery to be as comfortable and convenient as possible. After a breast biopsy, you may experience temporary pain and swelling at the biopsy site.
- Most Patients are able to engage in light activity while at home after surgery. Patients can remove any dressings and shower the day after the operation.
- Post-operative pain is generally mild and patients may require a pain pill or pain medication.
- Most patients can resume normal activities within a day or two, including driving, walking up stairs, light lifting, and work.
- You should call and schedule a follow-up appointment within 2 weeks after your operation.
what complications can occur?
Breast biopsy is generally considered extremely safe. As with any operation, there is a risk of a complication. Complications during the operation may include:
- Bleeding or hematoma
- Rarely infection of the wound
- Skin wound separation
- Adverse reaction to general anesthesia
when to call your doctor
Be sure to call your physician or surgeon if you develop any of the following symptoms after surgery:
- Persistent fever over 101 degrees F (39 C)
- Pain that is not relieved by your medications
- Persistent nausea or vomiting
- You are unable to eat or drink liquids
- Persistent cough or shortness of breath
- Purulent drainage (pus) from the incision
- Redness surrounding the incision that is worsening or getting bigger