A breast biopsy

A breast biopsy is a diagnostic procedure in which a sample of breast tissue is taken to make a definitive diagnosis. It is classified as:

• Aspiration biopsy;
• Core biopsy;
• Vacuum biopsy;
• Needle biopsy;
• Excisional biopsy.

Depending on the diagnostic method used, breast biopsies can be classified as:

• Stereotactic breast biopsy: during this type of breast biopsy, the doctor uses a mammography X-ray machine to locate the area of the breast that needs to be biopsied;
• Ultrasound-guided breast biopsy: During this breast biopsy, the doctor uses an ultrasound machine to locate the area of the breast that needs to be biopsied.
• MRI-guided breast biopsy: During this breast biopsy, the doctor uses a magnetic resonance imaging (MRI) machine to locate the area of the breast that needs to be biopsied.

Breast aspiration biopsy (fine needle)

Breast aspiration biopsy (fine needle) is a diagnostic procedure during which a sample of breast fluid is taken for detailed examination. An ultrasound device helps the doctor to accurately guide the needle to the site of the lesion. The procedure is usually performed with a thin 20–23G needle, which is used to take a fluid sample from the suspicious area. The fluid sample is sent to a pathology laboratory, where pathologists evaluate the material and make a final diagnosis of the pathology. However, in some cases, the material collected during an aspiration biopsy is not sufficient to make a diagnosis, in which case a core (thick needle) biopsy of the breast is recommended.

A breast core biopsy (thick needle)

A breast core biopsy (thick needle) is a diagnostic procedure in which a column of breast tissue is removed for detailed examination. An ultrasound device helps the doctor to accurately guide the needle to the site of the lesion. Small columns of breast tissue are removed using a special hollow needle (usually 3-4 columns are removed). The tissue columns are sent to a laboratory, where pathologists examine them and make a precise final diagnosis of the pathology. The final pathological report of a breast core biopsy is the most important test that confirms the diagnosis of the disease and determines the patient's further examination and treatment tactics.

Breast vacuum biopsy

A breast vacuum biopsy is a diagnostic procedure in which a suspicious tissue fragment is removed from the breast for detailed examination. An ultrasound device helps the doctor to accurately guide the needle to the site of the lesion. A special hollow needle is used to extract the suspicious breast tissue fragment using vacuum suction. The tissue fragment is sent to a laboratory, where pathologists examine it and make a precise final diagnosis of the pathology. The final pathological response of a breast vacuum biopsy is the most important test that confirms the diagnosis of the disease and determines the patient's further examination and treatment tactics.

Punch biopsy

A breast punch biopsy is a diagnostic procedure in which a piece of tissue is removed from the breast for detailed examination. Using a special device similar to a pen, a piece of breast tissue is taken directly from under the skin. The tissue sample is sent to a laboratory, where pathologists examine it and make a precise final diagnosis of the pathology. The final pathological response of a breast core biopsy is the most important test that confirms the diagnosis of the disease and determines the patient's further examination and treatment tactics.

Excisional breast biopsy

An excisional breast biopsy is a surgical procedure in which the doctor removes a suspicious breast lesion. During an excisional breast biopsy, the entire suspicious lesion and usually the surrounding tissue are removed. The removed tissue is sent to a laboratory, where pathologists examine the removed lesion and make an accurate final diagnosis of the pathology. The final pathological report of an excisional breast biopsy is the most important test that confirms the diagnosis of the disease and determines the patient's further examination and treatment tactics.

FAQ's questions about breast biopsy

When should a breast biopsy be performed?

Your doctor may recommend a breast biopsy if:

• Radiological examinations (ultrasound, mammography, or magnetic resonance imaging) reveal suspicious changes in the breast;
• You notice unusual changes in the nipple, including flaking, sores, or bloody discharge.

How to prepare for a breast biopsy?

Your doctor will give you specific instructions on how to best prepare. It is recommended that you do not take aspirin, anti-inflammatory drugs, or anticoagulants for several days before the procedure, as these may increase the risk of bleeding and bruising.

If you are scheduled for a breast biopsy, it is important to tell your doctor:

• If you are pregnant;
• If you are taking blood-thinning medication;
• If you are taking aspirin;
• If you have any health problems or have recently had surgery;
• If you are allergic, especially to local anesthetics.

How is a breast biopsy performed?

During a breast biopsy, you will need to undress to the waist and lie down on the examination table. The doctor will help you get into the most comfortable position and, using a clear water-based gel, will begin an ultrasound scan of your breasts using a transducer, which will transfer all the images to the ultrasound screen. The doctor will then examine the suspicious area of the breast where the biopsy will be performed. Once the exact area of the breast where the biopsy will be performed has been determined, the doctor will inject a local anesthetic, after which you will feel nothing. After the local anesthetic has been administered, the doctor will insert the biopsy needle into the abnormal breast tissue and take a sample for examination.

What should I expect during the procedure?

There are many types of breast biopsy procedures, and each one is slightly different. Your doctor will explain the steps of the procedure and answer any questions you may have. It is important to remain calm while the doctor performs the procedure.

During a breast biopsy, you can expect:

• A slight prick when the local anesthetic is injected;
• You may feel a little pressure when the pain medication is injected;
• You will experience slight discomfort.

What happens after the procedure?

After the procedure, the doctor may monitor you for up to 15 minutes to make sure you do not experience any side effects, including dizziness, nausea, or an allergic reaction. Local anesthesia will not cause you to feel tired or sleepy, so you will be able to drive yourself home.
After the procedure, it is recommended to:

• Bandage and care for the wound;
• Take pain medication;
• Rest and take it easy.

How long does a breast biopsy last?

The total duration of the procedure depends on the type of biopsy performed and your specific situation. In most cases, a biopsy can last between 20 and 40 minutes.

What is the recovery period after a breast biopsy?

If you have had an ultrasound-guided fine needle aspiration or core needle biopsy, you may experience some discomfort, but you will be able to resume your normal activities the next day. You are likely to feel slight discomfort at the biopsy site for a few days. Bruising may also occur after the procedure. To promote faster healing and avoid infection, you should follow your doctor's instructions for wound care.

What are the side effects or complications of the procedure?

Most breast biopsies are minimally invasive, and patients recover quickly. Possible complications after a breast biopsy include:

• Bruising;
• Bleeding;
• Swelling;
• Pain;
• Infection.

If you experience signs of infection, such as redness, swelling, and fever, contact your nearest medical facility as soon as possible.

How long does it take to get the results of a breast biopsy?

The final pathological report for a breast biopsy is usually available after 1-2 weeks, but this may vary.

The following factors affect the time it takes to receive breast biopsy results:

• Processing time;
• If special staining and procedures are required for the test;
• If the pathologist needs to examine more samples;
• If the pathologist needs a second opinion.

What do breast biopsy results mean?

The final pathological report of a breast biopsy is the most important test that confirms the diagnosis of the disease and determines the patient's further examination and treatment tactics. The breast specialist will explain the final results in detail and discuss them with you. He or she will also discuss whether you need additional tests, surgery, and/or treatment. Don't be afraid to ask questions.