Percutaneous Breast Biopsy

Side view of female breast with ducts and lobules ghosted in, showing needle biopsy of lump.Percutaneous breast biopsies are done by putting a needle or probe through the skin of the breast to remove tissue for testing. This type of biopsy can be done in a doctor’s office or in an outpatient setting. The needle or special probe is put through the skin of the breast to remove samples tissue that might be cancer. Once removed, the biopsy sample is sent to a lab for study. If a lump or breast change cannot be felt, an image-guided biopsy is done. In these cases, the breast change may be located using ultrasound guidance. Computer mapping, based on mammograms, can also help pinpoint breast changes and guide the needle to the right place. The type of percutaneous breast biopsy done depends on the size of the lump or breast change, where it is in the breast, how much it looks like cancer, other medical problems you may have, and your preferences. Be sure to talk to your doctor about the pros and cons of the type of biopsy that's best for you and what you can expect during and after the biopsy.  

Understanding the risks

Before the biopsy, your doctor will talk with you about the risks of the procedure:

  • There may be slight bruising or bleeding where the needle or probe is put through the skin.

  • There's a small risk of infection.

  • All percutaneous biopsies may provide a false-negative result. This means you may have cancer cells that don’t show up in the biopsy sample. If the results aren’t clear, you will likely need to have another type of biopsy; often one that removes more tissue.

During the biopsy

Percutaneous biopsies are usually done under local anesthesia. This means drugs are used to numb the area of the breast that the needle will be put into. There are several types of percutaneous breast biopsy procedures. The type of biopsy done will depend on the location and size of the breast lump or change. Here are brief descriptions of the most common types:

  • During a fine needle aspiration, a very thin needle is placed into the lump, and tissue or fluid is pulled into needle. No cut is needed. This type of biopsy takes only minutes to perform.

  • With a core needle biopsy, a larger needle is used to take out small cylinders or cores of tissue. The needle is inserted for each sample. No cut is needed.

  • With vacuum-assisted biopsy, the tube-like probe often is inserted only once. The breast tissue is gently suctioned into the tube, and a small rotating knife inside the tube removes the tissue. A small cut in the skin may be needed to put in the larger, hollow probe.

When needed, any of these biopsies can be image-guided.

After the biopsy

You can go home shortly after the biopsy, no matter which method is used. And you can return to your normal routine almost right away. You may have some bruising and swelling for a few days. Be sure you know what signs of problems are and when to call the doctor. Sometimes a small, freckle-like scar appears.

Ask your doctor when you can expect to know the results of your biopsy and how you will get them.

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