Breast Biopsy

You will be offered several options for diagnosis and treatment of your breast problem. The options will be given to you, recommendations will be made and you will be able to decide what works best for you.

When an abnormal mammogram, ultrasound, MRI or a palpable mass are found, a breast biopsy may be necessary to be sure that a cancer is not growing in the breast tissue. Minimally invasive breast biopsy is the method of choice to determine if a lesion is cancer, pre-cancerous or benign (not cancer). This means that samples of the tissue are extracted from the breast with guidance from a mammogram, ultrasound or MRI. It the mass is able to be felt, a minimally invasive biopsy can also be performed. Once the tissue is removed, it is sent to the pathologist to be evaluated.

What does the biopsy entail?

Obtaining an accurate diagnosis is the key to breast biopsy. The state-of –the-art method for the diagnosis of both cancer and non-cancerous or benign lesions of the breast is through a minimally invasive biopsy technique. (Consensus statement 2009 )The imaging method (mammogram, ultrasound , MRI) is chosen by how the lesion is best visualized and the type of biopsy whether it is a core biopsy, vacuum assisted biopsy or excisional biopsy is chosen by the surgeon or radiologist to allow for the most effective method that will make an accurate diagnosis.

With a core biopsy, a small needle biopsy device is inserted into the breast multiple times to obtain tissue to send to the pathologist for evaluation. With a vacuum assisted biopsy, the device is inserted once and several samples are removed. An open surgical excisional biopsy requires a trip to the operating room.

With an incisional biopsy a piece of breast tissue is removed. An excisional biopsy removes the entire lesion.

With a fine needle aspiration (FNA) your doctor will insert a skinny needle into a lesion or a lymph node in order to remove cells that can be evaluated under a microscope. An FNA may not be able to give your doctor all of the information they need to be certain that a breast lesion is not cancer. You may require an additional biopsy if the FNA is felt to be non-diagnostic. Your doctor should discuss all of these options with you before a biopsy is performed. FNA is often used to evaluate lymph nodes that are enlarged.