Our breasts change over time, and that’s the primary reason to perform self-exams and get regular mammograms. Any change or abnormality is worth exploring with a specialist and breast imaging technology. Often after imaging, a doctor may recommend a breast biopsy to dive deeper if there appears to be abnormal breast tissue.
There are a few types of breast biopsies and ways to prepare and stay proactive while you wait for the results.
Who Would Need A Breast Biopsy?
Biopsies are an additional screening option if, during a routine exam, there is an abnormality in the breast tissue or a lump in the breast. Mammograms, breast ultrasounds, and breast MRIs are all types of “next step” screenings from your doctor.
However, if the further screening still shows abnormalities in the breast tissue, your doctor may recommend a breast biopsy to help rule out cancer.
What Are the Types of Biopsies?
There are different types of biopsies that can be performed. The type of biopsy is based on a few different factors. According to the American Cancer Society, these factors include:
- Suspicion level of breast changes
- Size of abnormal tissue
- Location of the abnormality
- Number of suspicious areas
- Patient’s personal preference
Fine Needle Aspiration
If the size of the abnormal tissue is small, a fine needle aspiration biopsy may be recommended. Using a fine, hollow needle attached to a syringe, the biopsy sample (tissue and fluid) is taken. A pathologist can then examine the sample under microscope.
Core Needle Biopsy
Similar to the fine needle aspiration, the core needle biopsy also uses a needle and syringe; however, the needle is bigger to collect a larger sample. This allows more breast tissue to be examined. Often, several core samples are taken to look at various sites in the breast tissue.
These are typically only performed after a FNA or core needle biopsy for further testing if the results were unclear. Surgical biopsies include surgically removing part of the entire concern area to be thoroughly evaluated for breast cancer.
What Can You Expect During a Breast Biopsy?
With an FNA or core needle biopsy, you will typically be in your surgeon’s office (rather than the hospital). In some cases, localized anesthesia is used to numb the area where the needle is inserted, but it is not always necessary because the FNA needle is so small. An ultrasound is sometimes used to help guide where the needle is going to take the sample from, which may feel like additional pressure. The entire procedure takes 20-30 minutes, but collecting the sample only takes a few seconds.
Surgical biopsies are typically done in an out-patient setting. Patients are given local anesthesia along with an IV medication (twilight anesthesia) to decrease alertness. Surgical biopsies typically require a few stitches, which are usually removed after several days.
What Happens After?
Once the sample is collected, it is sent to the lab for a pathologist to evaluate for cancer cells, infection, or any other explanation for the abnormal sample.
These results can take several days to return to your doctor, who will then call you with the results to discuss either on the phone or in the office. If the result does come back cancerous, you may be referred to an oncologist, but if the result comes back normal you may just be referred for more frequent screening.
In some cases, if the sample shows calcification, cyst, or other noncancerous findings, no definitive plan is needed. You should always keep up with self-exams, however, to ensure you’re aware of any changes in your breast tissue.
So What Percentage of Breast Biopsies Are Cancer?
While breast cancer is one of the most common cancers in women (1 in 8 women will develop breast cancer at some point in their life), screening technology has made it easier and more effective to detect cancer early.
Only 20% of breast biopsies are cancerous, which is in large part due to these advancements in technology and screening allowing us to closely monitor changes in breast tissue to detect any suspicious tissue before it gets worse.