Once a suspicious abnormality or lump has been found in your breast, a biopsy to sample some of the tissue from the area is recommended. There are several ways to sample breast tissue, and your doctor will recommend the method that is best for your situation.
Some of the most used breast biopsy techniques are:
This technique is used when the abnormality is on the mammogram but cannot be felt in the breast or seen by ultrasound. It is often used to sample suspicious microcalcifications that can be the earliest sign of a developing cancer. The procedure is performed in the radiology department using a special table that allows the breast to be biopsied with a needle directed into the area of abnormality as a mammogram is being performed. Local anesthetic is used and the recovery from the procedure is minimal.
Ultrasound Guided Core Needle Biopsy
If the abnormality is visible on ultrasound, a needle biopsy can be performed under ultrasound guidance as part of the initial evaluation of the breast. Small cores of breast tissue are recovered directly from the area of abnormality and the biopsy results are available approximately 48 hours after the procedure. This biopsy technique produces a reliable answer in a short amount of time comfortably and safely. It is the technique of choice if the abnormality can be seen on ultrasound.
Open Surgical Biopsy
If a suspicious breast lump can be felt, but cannot be seen with mammography or ultrasound, the surgeon may have to surgically remove the lump to get a definitive diagnosis. Sometimes the surgeon may ask the radiologist to place a localizing wire into the area of the abnormality to help ensure that the suspicious abnormality is completely removed at the time of the operation. This technique is referred to as a “wire localized” breast biopsy. These surgical biopsies are performed in the operating room, are most comfortable with sedation in addition to local anesthetic, and they result in a small wound on the breast. For these reasons, an open surgical biopsy is usually only performed if a needle biopsy cannot be done.