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Breast biopsy - ultrasound

Definition

A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders.

There are several different types of breast biopsies, including stereotactic, open, and lumpectomy. This article focuses on needle-based, ultrasound-guided breast biopsies.

Alternative Names

Biopsy - breast - ultrasound; Ultrasound-guided breast biopsy; Core needle breast biopsy - ultrasound

How the test is performed

Before the procedure, you are asked to undress from the waist up. You wear a robe that opens in the front.

You are awake during the biopsy. You lie on your back. The health care provider first cleans the area on your breast, and injects a numbing medicine.

  • The doctor makes a very small cut on your breast over the area that needs to be biopsied.
  • The doctor uses an ultrasound machine to guide the needle to the abnormal area in your breast that needs to be biopsied.
  • Several biopsies may be taken.
  • A small metal clip or needle may be placed into the breast in the area of the biopsy to mark it, if needed.

The biopsy is done using one of the following:

  • Fine needle aspiration
  • Hollow needle (called a core needle)
  • Vacuum-powered device
  • Both a hollow needle and vacuum-powered device

Once the tissue sample has been taken, the catheter or needle is removed. Ice and pressure are applied to the site to stop any bleeding. A bandage is applied to absorb any fluid. You do not need any stitches after the needle is taken out. If needed, strips of tape may be placed to close the wound.

How to prepare for the test

The health care provider will ask questions about your medical history and perform a manual breast exam.

You must sign an informed consent form. If you are going to have general anesthesia, you may be asked not to eat or drink anything for 8 to 12 hours before the test.

If you take medicines (including aspirin or herbal medications), ask your doctor whether you need to stop taking these before the biopsy.

Tell your doctor if you may be pregnant before having a biopsy.

Do not apply lotion, perfume, powder, or deodorant underneath your arms or on your breasts.

How the test will feel

When the doctor injects the numbing medicine, it may sting a bit.

During the procedure, you may feel slight discomfort or light pressure. You should not feel any pain.

After the test, the breast may be sore and tender to the touch for several days. Do not do any heavy lifting or work with your arms for 24 hours after the biopsy. Use acetaminophen (Tylenol) to relieve pain.

Although you may have some bruising, there should be no scars left in the breast or on the skin.

Why the test is performed

An ultrasound-guided breast biopsy may be done to evaluate abnormal findings on a mammogram or breast ultrasound, or during a physical exam.

To determine whether someone has breast cancer, a biopsy must be done. Tissue and fluid from the abnormal area are removed and examined under a microscope.

Normal Values

A normal result means there is no sign of cancer or other breast problems.

Your doctor or nurse will let you know if and when you need a follow-up mammogram or other tests.

What abnormal results mean

A biopsy can identify a number of breast conditions that are not cancer or precancer, including:

Biopsy results may show precancerous breast conditions, such as:

Abnormal results may mean that you have breast cancer. Two main types of breast cancer may be found:

  • Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
  • Lobular carcinoma starts in parts of the breast called lobules, which produce milk.

Depending on the biopsy results, you may need further surgery or treatment.

What the risks are

There is a slight chance of infection at the injection or incision site. Excessive bleeding is rare.

References

Abeloff MD, Wolff AC, Weber BL, et al. Cancer of the breast. In: Abeloff MD, Armitage JO, Niederhuber JE, et al., eds. Clinical Oncology. 4th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2008: chap 95.

Whitman GJ. Ultrasound-guided breast biopsies. Ultrasound Clin. 2006;1:603-615.

Kim CH, Bassett LW. Imaging-guided core needle biopsy of the breast. In: Bassett LW, Jackson VP, Fu KL, Fu YS, eds. Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2005:chap 17.

Review Date: 2/13/2013
Reviewed By: Ken Levin, MD, private practice specializing in Radiology and Nuclear Medicine, Allentown, PA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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