Biopsy

You have several options when considering a breast biopsy. The choices range from a surgical procedure performed in an operating room to new minimally-invasion procedures that barely leave a mark and are performed in the doctor’s office. Today, you and your doctor have three key biopsy choices to help rule out breast cancer.

Fine needle aspiration (FNA) is the least invasive method of biopsy and it usually leaves no scar. You will be lying down for this procedure. First, an injection of local anesthesia is given to numb the breast. The surgeon or radiologist uses a thin needle with a hollow center to remove a sample of cells from the suspicious area. In most cases, he or she can feel the lump and guide the needle to the right place. A thin needle is placed into the lump. If fluid comes out, and the lump disappears, it means that the lump is a cyst and is usually not cancer. FNA however, does not allow these cells to be compared to surrounding tissue for the most accurate diagnosis.

Core needle biopsy uses a larger hollow needle than what is used for fine needle aspiration. This type of biopsy is done while you are lying down. After numbing the breast with local anesthesia, the surgeon or radiologist uses the hollow needle to remove several cylinder-shaped samples of tissue from the suspicious area. In most cases, the needle is inserted about 3 to 6 times so that the doctor can get enough samples. Usually core needle biopsy does not leave a scar.

If the lesion cannot be felt through the skin, the surgeon or radiologist may use an image-guided technique such as ultrasound-guided biopsy or stereotactic needle biopsy. A small metal clip may be inserted into the breast to mark the site of biopsy in case the tissue proves to be cancerous and additional surgery is required. This clip is left inside the breast and is not harmful to the body. If the biopsy leads to more surgery, the clip will be removed at that time.

Vacuum-assisted breast biopsy is a newer way of performing breast biopsy. Unlike core needle biopsy, which involves several insertions of a needle through the skin, vacuum-assisted biopsy uses a special probe that only needs to be inserted once. The procedure is also able to remove more tissue than core needle biopsy.

For vacuum-assisted breast biopsy, you’ll lie face down on an exam table with special round openings where your breasts will be placed. First, an injection of local anesthesia is given to numb the breast. Guided by mammography (stereotactic-guided biopsy) or ultrasound, the surgeon or radiologist places the probe into the suspicious area of the breast. A vacuum then draws the tissue into the probe.

A rotating cutting device removes a tissue sample and then carries it through the probe into a collection area. The surgeon or radiologist can then rotate the probe to take another sample from the suspicious lesion. This can be repeated 8 to 10 times so that the entire area of concern is thoroughly sampled. In some cases, a small metal clip is placed into the biopsy site to mark the location, in case a future biopsy is needed. This clip is left inside the breast and causes no pain or harm. If the biopsy leads to more surgery, the clip will be removed at that time.