A biopsy is the removal of breast tissue that’s examined under a microscope by a pathologist. Just because your radiologist requested a biopsy doesn’t mean you have breast cancer. Most biopsy results are not cancer.
We use several methods of needle biopsy, and your radiologist will determine the best method for you. Because the area of the breast is numbed with local anesthesia, biopsies are relatively painless, and you can go home shortly after the procedure.
Ultrasound-Guided Breast Biopsy
If an abnormal breast mass is detected on the ultrasound or a breast lump is found, a radiologist can use ultrasound guidance to pinpoint the mass and take samples.
There are two methods of ultrasound-guided breast biopsy. In one method, called a core needle biopsy, samples are taken by way of a spring-loaded biopsy needle. Another method, a vacuum-assisted biopsy, applies pressure to pull tissue from the breast through the needle into the sampling chamber.
A stereotactic breast biopsy relies on special imaging to place the biopsy needle at precisely the site of the abnormality. A specialized mammography machine, similar to the mammography unit used for diagnostic screening, is used.
X-rays are taken from different angles to help guide the radiologist's instruments to the site. Using a vacuum-assisted device, samples are obtained and sent to a pathologist for diagnosis.
Surgical or Excisional Breast Biopsy
Most breast biopsies are done with special needles using image guidance. Sometimes, a needle biopsy isn’t possible due to the location of the suspicious area in the breast. In these cases, the biopsy is done by a surgeon in an operating room.
Before surgery, a seed-localization procedure — like magnetic seed localization — is usually done if the abnormal area in the breast was first detected on imaging tests like a mammogram. A Magseed marker, which is a small seed placed in soft tissue, may be used in this process.
The surgeon will use local anesthetic to numb the area and you will also get IV sedation, rather than general anesthesia. These procedures are done in an outpatient setting and you can likely go home the same day.
An MRI-Guided Vacuum-Assisted Breast Biopsy
An MRI uses powerful magnetic fields and advanced computer technology to produce specific images of the breast. Using MRI guidance to pinpoint the mass, vacuum pressure is used to pull tissue from the breast through the needle into the sample chamber.