What is a breast biopsy?

A breast biopsy is a test that takes a small tissue sample from a specific breast area. This tissue sample is then sent to the lab, where it’s examined closely under a microscope to help diagnose breast conditions.

Your doctor may order a breast biopsy after an imaging test, like a mammogram, shows an area that needs more testing. While imaging tests can’t diagnose breast cancer, a breast biopsy can give you the answers you need when you have a lump or spot in your breast. If you need a breast biopsy, the good news is that about 8 out of 10 breast biopsies come back benign—or show no signs of cancer.

Types of breast biopsies

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There are several different kinds of breast biopsy procedures that your care team may recommend to check on your breast health. Some use a needle to take a tissue sample, while others use surgery. Many breast biopsies use imaging technology, like X-rays, ultrasound or MRI, to provide images of your breast tissue and ensure the biopsy is taken from a precise location in the breast.

The type of breast biopsy that’s right for you depends on your unique health and the area of concern in your breast. Your team will use factors like the size, location and shape of the spot or lump to help decide which test is recommended.

Fine needle aspiration (FNA) biopsy

Fine needle aspiration uses a small needle to remove fluid or cells from a lump in your breast. This type of biopsy is often used when your care team suspects a lump is a breast cyst. Removing the fluid in this procedure sometimes helps a breast cyst go away.

Core needle biopsy

During a core needle biopsy, your care team uses a larger needle to take cylinder-shaped tissue samples, often called cores, from a specific area in the breast. Your team may use imaging to better look at the place of concern and guide a needle biopsy to the right spot.

Sentinel node biopsy

Sentinel node biopsy is a surgical procedure that helps find which lymph nodes may be the first to be affected by the spread of breast cancer. It’s often used after you’ve already been diagnosed to determine the stage of your breast cancer.

Samples of the identified sentinel lymph nodes are taken and sent to the lab to look for signs of cancer. If no cancer is found in the sentinel nodes, it’s a good sign that breast cancer hasn’t spread to other lymph nodes.

Surgical biopsy

A surgical biopsy is a breast biopsy procedure that uses an incision in your breast while under general anesthesia to remove part of a lump or all of a suspicious breast lump. Sometimes, your care team may use imaging and a wire to locate and mark the lump before the surgical biopsy.

  • Incisional biopsy - An incisional biopsy is a surgical biopsy that only removes a sample or part of your breast lump.
  • Excisional biopsy - An excisional biopsy, called a lumpectomy, removes the entire breast lump and some of the tissue around it. This procedure helps diagnose and treat cancer.

Stereotactic breast biopsy

Stereotactic breast biopsy uses X-ray images of the breast, or mammography, to help guide the biopsy needle precisely in the right spot. Then, your care team takes tissue samples through the needle to be examined in the lab.

Watch a video about stereotactic biopsy and breast imaging at Baylor Scott & White Health

Ultrasound-guided breast biopsy

An ultrasound breast biopsy is a biopsy procedure that uses a breast ultrasound to help guide the biopsy needle to precisely the right spot. Then, your care team takes tissue samples through the needle to be examined in the lab.

Watch a video about ultrasound-guided biopsy and breast imaging at Baylor Scott & White Health

MRI-guided breast biopsy

MRI, or magnetic resonance imaging, can also guide a breast biopsy. An MRI-guided breast biopsy uses a breast MRI  to help place a needle in the right spot before taking tissue samples.

Breast biopsy procedure

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When you need a breast biopsy procedure, our team is here to make you as comfortable as possible and walk you through each step. Your preparation, procedure and recovery steps will be based on the type of biopsy you have. Generally, the process should take between 20 minutes to about an hour.

Usually, a needle biopsy is less invasive and only requires local numbing on your breast. Sometimes, surgical biopsy includes general anesthesia, which means you’ll be asleep for the procedure. Also, depending on the type of biopsy you need, you may have wire placement ahead of time to help your care provider plan the exact location of your breast biopsy.

Preparation for breast biopsy

Before your biopsy, you can take a few steps to help you feel more prepared and comfortable on the day of your procedure. Make a list of questions for your provider so you understand what to expect.

Tell your care team about:

  • All medications you take, including blood thinners, aspirin, over-the-counter drugs and supplements
  • Any allergies or if you’ve had a past reaction to anesthesia
  • Any chance you are pregnant
  • All health conditions you have, especially bleeding disorders

If you have general anesthesia during your biopsy, your care team will provide you with specific instructions about eating and drinking before your procedure. You’ll also want to plan to have someone with you at your procedure to drive you home.

During the breast biopsy

The exact steps of your breast biopsy vary depending on the type of procedure you have and if any imaging guidance is used during the process.

In general, here are some of the steps you can expect during a breast biopsy:

  • You’ll change into a gown for the procedure.
  • Imaging, such as X-rays, ultrasound or MRI imaging, will be taken to help guide the procedure.
  • A sterile solution will be used to clean the skin on your breast.
  • Your team will give you either local anesthesia or general anesthesia. If you’re awake, you shouldn’t feel pain but may still feel some pressure.
  • For a needle biopsy, a needle will be inserted directly into the breast or using a minimal incision. For a surgical biopsy, a small incision will be made.
  • Samples of the tissue or the entire lump will be removed.
  • Sometimes, special metal markers will be placed where the biopsy was taken.
  • Bandages, stitches or adhesive strips will be placed over the biopsy spot as needed.
  • The tissue samples will be sent to the lab for testing.

After the breast biopsy

After your biopsy, your doctor will give you details about how to care for yourself at home. If you had a needle biopsy, you’ll usually be able to return to your normal activities the next day. When recovering from a surgical biopsy, it can take a few days or up to a week before you start to feel back to normal.

With all biopsies, it’s normal to have some discomfort around the biopsy site. Your healthcare provider will recommend pain relievers to help with discomfort. You may also wear a supportive bra or place an ice pack on the area for a few minutes to help.

Always contact your doctor if you have signs of an infection, such as:

  • Increased redness or swelling
  • Pain that gets worse
  • Fever and chills

Breast biopsy results

You can expect it to take up to a week or two to get the results back from your breast biopsy. All tissue samples taken during a biopsy are sent to a lab for processing. The timing depends on what tests are needed, how many samples are examined and if more than one opinion is necessary.

A pathologist, a doctor specially trained in analyzing blood and tissue samples, looks at your samples and provides your biopsy results in a report. This report will tell you if the pathologist found no signs of cancer, pre-cancerous changes or breast cancer. It will also include details about the types of cells present. Your doctor can help explain the report’s details and answer your questions.

If no cancer cells are found, you may be diagnosed with a benign breast condition. Your doctor will inform you if additional testing or follow-up is needed to monitor your health.

If cancer cells are found, the report will provide details about the type of cancer cells in your breast, which helps guide your treatment. Your doctor will refer you to a team of cancer specialists to get you the care and support you need.

Our breast imaging centers near you

We offer several locations for your care, including women’s imaging centers in North and Central Texas that provide breast biopsy options to fit your needs.

Frequently asked questions

  • Is breast biopsy painful?

    A breast biopsy isn’t usually painful. Anesthesia helps prevent you from feeling pain, and you may only feel a little discomfort or pressure during the procedure. After your biopsy, your provider will guide you on medications you can take to manage pain.

  • How long does a breast biopsy take?

    On average, a breast biopsy takes 20-60 minutes. Needle biopsies are usually faster, while a surgical biopsy might take longer. Your care team will let you know what to expect based on your specific type of biopsy.

  • What percentage of breast biopsies are cancer?

    Only about 20% of breast biopsy results show cancer. Breast biopsies are a standard procedure to help check your breast health. They often give you peace of mind that an area of concern or lump isn’t cancer.

  • What not to do before a breast biopsy?

    You should not take certain medications before a breast biopsy that can increase your risk of bleeding. These include blood thinners, aspirin, anti-inflammatory medications and some vitamins or supplements. For a surgical biopsy, you may not be able to eat or drink after midnight before your surgery.

  • Can a breast biopsy cause cancer to spread?

    No. A breast biopsy won’t cause cancer to spread. Taking a tumor sample doesn’t increase the likelihood of it growing or spreading. By identifying cancer cells, a breast biopsy helps you get the treatment you need for cancer.