Biopsies are the only definitive way to confirm if breast tissue is benign or cancerous.
Needle Biopsy Of The Breast
Needle biopsy is a safe, minimally invasive procedure used to get a sample from an abnormal breast lesion. Small amounts of breast tissue are removed through a needle, and a pathologist will study the tissue is studied under a microscope and provide a diagnosis. There are various methods a needle biopsy can be performed.
An ultrasound-guided biopsy is a technique most often used to guide a breast biopsy when a breast abnormality is visible on ultrasound.
Stereotactic Breast Biopsy
A stereotactic breast biopsy allows for a needle biopsy to be performed on lesions which are more conspicuous on mammography than on ultrasound. This type of biopsy utilizes x-ray images (mammograms) of the breast tissue to guide the biopsy needle to the area of interest. Stereotactic biopsies are most commonly performed on tiny breast calcifications, but may also be utilized on breast masses in certain situations.
An MR-guided biopsy is the latest development and an important advance in diagnosing breast cancer. It is most useful when an ultrasound or stereotactic-guided biopsy is not appropriate because the area of concern is not well seen by mammogram or ultrasound, but is discovered or is most conspicuous on MRI.
What Should I Expect?
When you arrive you will be asked to complete paperwork regarding your history and symptoms. If it makes you feel more comfortable, you may want a relative or friend to join you to lend support and drive you home.
We realize a biopsy may be an emotionally distressful experience. However, patient comfort — in addition to an accurate diagnosis — is our priority. Our radiologists and staff are trained to make this procedure as comfortable and quick as possible. Keep in mind that more than 80 percent of all breast abnormalities are benign or non-cancerous.
A needle biopsy can be performed with local anesthetic and minimal discomfort. With this procedure, no stitches are required and most women can resume normal daily activity immediately.
- do not take aspirin or Ibuprofen for 5-7 days prior to biopsy.
- prior to your appointment, let the staff know if you are taking any blood thinners.
- wear a supportive bra to help maintain the post-biopsy dressing.
- wear a two-piece outfit, preferably one that buttons up the front.
- do not change your eating habit.
- do not eat a large meal immediately prior to the exam.
- arrive about 30 minutes before your appointment.
If you have minor claustrophobia or anxiety, you may want to ask your physician for a prescription for a mild sedative. Do not take this medication prior to your arrival or signing paperwork.
Ultrasound Guided Biopsy
You will lie on your back or turn slightly to the side. The ultrasound wand is used to locate the lesion. Local anesthetic is injected to ensure that you will be comfortable. The radiologist will then create a small nick in the skin through which the biopsy needle will be inserted, and several samples of tissue will be obtained for evaluation. When the tissue sampling is complete, a small marking clip may be left at the site of biopsy, so it can be easily located for future follow up if surgery becomes necessary.
Stereotactic Breast Biopsy
This minimally invasive procedure requires you to be positioned lying face down on a specially designed table used specifically for breast biopsies. Your breasts are actually positioned through an opening in the table. We will then clean the skin and inject a local anesthetic. A tiny incision less than a quarter of an inch is made without causing any significant alteration in the appearance of the breast. The radiologist will remove several samples of tissue through this incision. When the tissue sampling is complete, a small marking clip may be left at the site of biopsy, so it can be easily located for future follow up if surgery becomes necessary.
During an MR-guided biopsy, a local anesthetic is injected into the breast to numb it and contrast material is given intravenously. You will be positioned face down on your stomach and your breast(s) will be positioned into a cushioned opening containing a special breast-imaging coil. Using computer software, the radiologist determines the position and depth of the lesion for biopsy. When the tissue sampling is complete, a small marking clip may be left at the site of biopsy, so it can be easily located for future follow up if surgery becomes necessary.
You will be asked to remove all jewelry, since these items disturb MRI signals. It is very important that any prior breast films (mammograms, ultrasound or MRI) be available to the radiologist for comparison. If you have had these at a facility other than Iowa Clinic Medical Imaging, please let us know so we may obtain the films for comparison or bring them with you on the day of your appointment.
Many of these items are contraindications to having an MRI as they are not compatible with the magnetic field present around all MRI machines. If you have any of the items listed below, call 515.244.5109 so we can make arrangements for you before your appointment.
- Cardiac Pacemaker
- Artificial heart valve prostheses
- Aneurysm clips
- Eye implants or metal ear implants or any metal implants activated electronically, magnetically or mechanically
- Copper 7 IUD
- Shrapnel or non-removed bullet
- Weight over 350 lbs
- Any metal puncture(s) or fragment(s) in eye
What Instructions Do I Follow After The Procedure?
After your biopsy, do not participate in any strenuous activity or take aspirin for 48 hours. You may take Tylenol or Ibuprofen (Advil, Nuprin, Motrin) if needed for any discomfort. The outer dressing may be removed after 24 hours. Do not get the area wet until this is done. The steristrip may be removed five days after the biopsy. You may bathe carefully with the steristrip in place, being careful not to loosen them.
You may have some discomfort or bruising at the skin incision site. Watch for excessive bleeding, pain or fever. Should any of these occur, contact our office by calling 515.244.5109.
When Will I Get The Results?
Biopsy samples are sent to a Pathologist, who will analyze and provide your physician and Iowa Clinic Medical Imaging with a diagnosis. You will be notified of your results within several days of your biopsy appointment.