A procedure in which tissue is taken from a mass, mass-like finding, or microcalcification detected in the breast using a needle or surgical method to establish a pathological diagnosis.
Indication
- Suspicious lesions categorized as BI-RADS 4 and 5 detected on imaging
- Detection of firmness, asymmetry, or a mass on clinical examination
- Suspicious microcalcification clusters on mammography
- Solid, irregularly bordered masses on breast ultrasound
- Foci showing dense or rapid contrast uptake on breast MRI
- Radiological findings accompanied by nipple discharge or skin changes
- Lesions previously reported as benign but changing on follow-up
Preparation
- Use of blood thinners is adjusted with physician approval 5-7 days before the procedure
- Mammography, ultrasound, or MRI images are reviewed before the procedure
- Active breast infection is treated first if present
- Fasting is usually not required since local anesthesia is sufficient
- Wearing comfortable, front-opening clothing is recommended
How it's performed
- The patient is positioned supine or on their side, and the lesion site is marked
- The skin is cleaned with antiseptic solution and covered with a drape
- Ultrasound, mammography (stereotactic), or MRI guidance is used to access the lesion
- After local anesthesia, core needle biopsy is performed with a tru-cut needle; vacuum-assisted biopsy may be preferred for microcalcifications
- Excisional biopsy (surgical removal) is performed when needed for superficial or poorly defined lesions
- Samples are sent to the pathology laboratory; bleeding control and pressure dressing are applied
Post-procedure
- 20-30 minutes of observation after the procedure is sufficient; the patient returns home the same day
- Heavy lifting and intense exercise are avoided for the first 24 hours; cold application reduces bruising
- The dressing can be removed after 24-48 hours; bathing follows physician recommendation
- Pathology results are typically evaluated within 5-10 business days
- Follow-up imaging, additional intervention, or multidisciplinary council planning is arranged based on the result
Risks
- Pain, bruising, and hematoma at the biopsy site (approximately 2-5%)
- Skin infection (possible with any surgical procedure, rare)
- Need for repeat biopsy due to insufficient sampling in tru-cut and vacuum biopsies
- Small scar and temporary sensory changes after excisional biopsy
- Very rarely pneumothorax (in deep lesions very close to the chest wall)
FAQ
Is breast biopsy a painful procedure?
Since the procedure is performed under local anesthesia, generally only a sensation of pressure is described rather than pain; mild soreness may persist for a few days afterward.
How long do I wait for my biopsy result?
Standard pathological examination takes 5-10 business days; this period may be extended when additional immunohistochemical tests are needed.
Does needle biopsy carry a risk of spreading cancer?
Current literature and large-series studies show that needle biopsy does not increase the risk of breast cancer spread.
What is done if my result is benign?
Follow-up imaging is generally planned at 6-12 month intervals; surgical excision may be recommended for some high-risk lesions.
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