box-biopsyBreast Biopsies. With advances in screening programs and diagnostic tests such as digital mammograms, ultrasound and MRI, physicians are identifying breast abnormalities earlier. Sometimes the results of these imaging tests lead physicians to recommend a breast biopsy.

  • In the past, a biopsy required an open surgical procedure that could leave an external scar, cause a breast deformity or even interfere with future screening mammograms.
  • Today, most experts agree that minimally invasive breast biopsy reduces the potential disfigurement for patients with breast abnormalities and can eliminate the need for the patient to undergo an open surgical diagnostic procedure for most noncancerous findings.[5]
  • The pathology results are also back sooner so answers are known more quickly.
  • Minimally invasive biopsies also cause less scarring inside the breast. This means that new mammogram images do not look abnormal due to scarring from surgical biopsies – which can result in patients needing additional imaging or even additional biopsies to confirm it is scar tissue and not a new lesion.

 

Biopsy Types

Open Surgical Biopsy Core Needle Biopsy Vacuum-assisted Biopsy
Facility Performed in an operating room or outpatient center. Performed in a doctor’s office or outpatient center. Performed in a doctor’s office or outpatient center.
Procedure Description A 1- to 2-inch incision is made to remove a tissue sample to be tested. Sample could be as large as a golf ball. A spring-loaded needle is inserted 3 to 6 times to cut and remove small pieces of tissue for testing. A small probe is inserted once and gently vacuums and removes tissue for testing.
Accuracy Used when core or vacuum-assisted biopsy not possible or after atypical or discordant results on core biopsy; 97% of targeted lesions successfully removed. Excellent technique for sampling masses; 98% accurate. Used for calcifications and findings seen only on MRI; larger amount of tissue retrieved than in core biopsy; 97% accurate.
Stitches Surgery includes stitches or glue. No stitches. No stitches
Scars and Future Mammograms External scar 1 to 2 inches; usual hematoma or seroma at surgical site for months to years; internal scar can interfere with future mammograms. Minimal or no scar; rare hematoma; no interference with future mammograms; no disfigurement. Minimal or no scar; 3% risk for hematoma up to golf-ball size; usually no interference with future mammograms; virtually no risk for disfigurement.
Anesthesia & Recovery Patient is under twilight or general anesthesia (sedated); she may experience some pain and soreness. Patient is awake; no recovery time; resumes work and normal activities immediately. Patient is awake; no recovery time; resumes work and normal activities immediately.
Not all women are candidates for each of these breast biopsy options. Each type of biopsy has pros and cons. The choice of biopsy type depends on factors such as how suspicious the tumor looks, where it is located in the breast, how large the tumor is, other medical problems you might have and your personal preferences. Consult with a physician to determine the breast biopsy option that meets your health needs.

Pathology Report

The results of a biopsy are reported to your doctor in a pathology report. Understanding the key parts of your pathology report is important so that you can make the best decisions about treatment options. However, pathology reports can be confusing to read because they are written for and intended for physicians. Breastcancer.org has a simple Pathology Report Checklist that will help you to understand your report:



Sources & Resources

Society, A.C., Breast Cancer Facts & Figures 2013-2014. 2013.
Hunt, B.R., S. Whitman, and M.S. Hurlbert, Increasing Black:White disparities in breast cancer mortality in the 50 largest cities in the United States. Cancer Epidemiol, 2014. 38(2): p. 118-23.
Wild, B.W.S.a.C.P., World Cancer Report 2014 2014.
Ross, A.C., et al., The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab, 2011. 96(1): p. 53-8.
Silverstein, M.J., et al., Special report: Consensus conference III. Image-detected breast cancer: state-of-the-art diagnosis and treatment. J Am Coll Surg, 2009. 209(4): p. 504-20.

Disclaimer

This website was created for educational purposes only and should not be interpreted as medical advice. Be sure to partner with your medical provider to develop the best personal care plan for you. Adapted from the American Cancer Society, 2013-2014 Breast Cancer Facts & Figures.