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A breast biopsy involves taking a piece of tissue and/or fluid from the breast, usually to test for breast cancer.

Who is a candidate for the procedure?

A breast biopsy is often needed when breast lumps are found on physical exam. Women with an abnormal mammogram are often also advised to have a biopsy. Other unexplained breast problems may need a biopsy to determine the cause. Most biopsies are done to determine whether breast cancer is present.

How is the procedure performed?

Tissue samples for a breast biopsy may be obtained with the following procedures:

• Fine needle aspiration. Local anesthesia is used to numb the area. The healthcare professional uses a thin needle to obtain fluid and cells from the lump.
• Needle biopsy. Local anesthesia is used to numb the area. If the lump is seen only on mammogram, a needle is guided under X-ray or ultrasound guidance to take a sample.
• Incisional biopsy. The woman is generally put to sleep with general anesthesia. The healthcare professional removes a sample of the lump or suspicious tissue.
• Excisional biopsy. The woman is generally put to sleep with general anesthesia. The healthcare professional removes all of the lump or suspicious tissue, as well as a surrounding area of healthy tissue.

The fluid and tissue will be carefully studied to determine first if it is cancer. If it is, the tissue then will be tested to see what cell type the cancer is, how fast it is likely to spread, and what kinds of chemotherapy or hormonal therapy are likely to be effective against it.

What happens right after the procedure?

After the procedure, a woman who has had an anesthetic is taken to the surgery recovery room and watched until the medications have worn off. After this, she is usually allowed to go home. If a woman was put to sleep during the procedure, someone else must drive her home.

Mild pain, responsive to over-the-counter pain medications, is normal after the procedure.

The healthcare professional then gives the individual and her caregiver(s) instruction on how to care for the wound. Written instructions are very helpful.

What happens later at home?

A woman who had only local anesthesia for the biopsy can return to normal activities immediately.

A woman who had general anesthesia usually needs about 24 hours to recover, and should not drive during this time. The incision site should be kept clean and dry.

After the procedure, the breast will be tender for a few days. Putting ice bags on the area on the day of the operation and cutting back on activity will help. The woman should wear a bra at all times, even when sleeping, to support the breast and reduce pain for the first 3 to 5 days. Pain medications should be taken as needed.

Biopsy results often take a few days to come back. The healthcare professional will discuss the results of the biopsy and what they mean. Most biopsies show normal or other noncancerous results. A smaller number will show breast cancer.

What are the potential complications after the procedure?

Any surgery can cause bleeding, infection, or a reaction to the anesthetic. Some women have a small amount of bleeding around the incision. If the dressing must be changed more than twice, the person should call the healthcare professional.

If a breast lump is removed, the healthcare professional tries to make the cavity left behind as small as possible. The tissue around the space where the lump was removed may weep, filling the cavity with thin, watery fluid or blood. This is usually absorbed by the body and is generally of no concern.

The site becomes infected in less than 5% of cases. Infection is suspected if the breast becomes more tender after the third day following the biopsy, if there is redness or pus around the incision, or if a fever develops. Any new or worsening symptoms should be reported to the healthcare professional.