If your surgeon determines that a breast biopsy is needed, we will inform you at the time of your office visit or after the appropriate imaging (ultrasound or mammogram) has been obtained.
Sometimes changes are only visible on the mammogram. If this is the case, you may need to go back for a mammogram-guided biopsy, called a stereotactic biopsy, in the radiology department. Our office will help you coordinate this.
Sometimes the area may be visible only under ultrasound. In this case, the biopsy can occur either in the radiology department or in our office using our ultrasound machine. Your surgeon will make this decision, and our office will help you coordinate this.
Sometimes an area can be felt or “palpated.” This will usually be biopsied in the office, or sometimes in the operating room. Again, your surgeon will explain what type of biopsy is best for you.
If you have a biopsy in the office, we will work with you to schedule it as soon as possible. This is usually within the week. Same day biopsies are typically not available because of insurance and scheduling constraints.
When you come in for your biopsy, please wear comfortable clothing and have a sports bra available. The front hook types are preferable. Sometimes the cleaning solution can get on your clothes despite our best efforts so please don’t wear you nicest clothing to your biopsy appointment!
The procedure takes 20 to 40 minutes. If possible, please don’t bring young children as they are usually quite bored.
Please let you doctor know if you are prone to nerves or fainting. You may be given a prescription for a medication to take before the procedure to reduce anxiety. If so, you will need somebody to drive you to and from your appointment.
Core (Needle) Biopsy
For a core ( needle) biopsy your breast will be cleaned (prepped) with a sterile solution and a small area anesthetized with numbing medicine (like at the dentist). Once the area is numb, a small (1/4 inch) nick will be made in the skin to allow the biopsy device to be inserted. Then using ultrasound or palpation, the area of concern will be sampled. The device to take the
tissue samples makes some noise, but your surgeon will demonstrate it for you so you know what to expect. After an adequate sample of tissue has been taken, the incision will be closed with Steri-strips (paper tapes) and a dressing applied. Sometimes your surgeon will want to keep some pressure on the area, in order to decrease the amount of bruising or prevent a hematoma (a big bruise/blood collection in the tissues). Sometimes your surgeon will want you to wear a support or sports bra for 24-48 hours to put gentle pressure on the area. Either way some bruising is to be expected and can take a few weeks to go away completely. The incision in the skin is usually healed within a week and is hardly noticeable.
When you go home you can take Tylenol for pain. Your surgeon may not want you to take ibuprofen (Advil, Motrin) or aspirin, as it can increase bleeding. Your doctor may give you a prescription medicine to take, if needed. Leave the dressing on for 48 hours (or as instructed) and then you can remove it. You can bathe but try to keep the area dry for 48 hours. The paper tapes will fall off, or you may remove them after 7 days.
Most women will have some bruising and some mild pain in their breast. Most are able
to return to work the next day but try to limit heavy physical activity for a few days.
Results are usually available in 3-4 business days. You surgeon may want you to come in and discuss the results.
Excisional or Incisional Biopsy
Sometimes your surgeon will want to perform a larger biopsy. In this case, the procedure is similar to what is described above but may take a little longer and may have a bigger incision. Sometimes this can be performed in the office, or your surgeon may want to do it in the operating room. The procedure is usually a little longer, and the incision is usually about an inch or less.
With this type of procedure, you may need a day or two off work. After your procedure the doctor will usually have you come back in a week for a recheck and to discuss the results of the biopsy. Feel free to bring a family member or friend to the biopsy appointment or to discuss the results, if you think it would help you to have someone else present.