Breast biopsy - ultrasound

Definition

A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders.

There are several different types of breast biopsies. This article focuses on needle-based and ultrasound-guided breast biopsies.

See also:

• Breast biopsy - stereotactic
• Breast biopsy - open
• Lumpectomy

Alternative Names

Biopsy - breast - ultrasound; Ultrasound-guided breast biopsy; Core needle breast biopsy - ultrasound

How the test is performed

Before the procedure, you will be asked to undress from the waist up. You will wear a robe that opens in the front.

You will be awake during the biopsy. You will lie on your back. The health care provider will first clean the area on your breast, and then inject a numbing medicine.

• The doctor will make a very small cut on your breast over the area that needs to be biopsied.
• The doctor will use an ultrasound machine to guide the needle to the abnormal area in your breast that needs to be biopsied.
• Several biopsies may be taken through the same needle or catheter.
• A small metal clip or needle may be placed into the breast in the area of the biopsy to mark it, if needed.

The biopsy is done using fine needle aspiration, a hollow needle (called a core needle), a vacuum-powered device, or a hollow needle and vacuum-powered device.

Once the tissue sample has been taken, the catheter or needle is removed. Ice and pressure are applied to the site to stop any bleeding. A bandage will be applied to absorb any fluid. You will not need any stitches after the needle is taken out. Steri-strips may be placed over any wound, if necessary.

How to prepare for the test

The health care provider will ask questions about your medical history and perform a manual breast exam.

You must sign an informed consent form. If you are going to have general anesthesia, you may be asked not to eat or drink anything for 8 - 12 hours before the test.

If you take medications (including aspirin or herbal medications), ask your doctor whether you need to stop taking these before the biopsy.

Tell your doctor if you may be pregnant before having a biopsy.

Do not wear lotion, perfume, powder, or deodorant underneath your arms or on your breasts.

How the test will feel

When the doctor injects the numbing medicine, it may sting a bit.

During the procedure, you may feel slight discomfort or light pressure. You should not feel any pain.

After the test, the breast may be sore and tender to the touch for several days. Do not do any heavy lifting or work with your arms for 24 hours after the biopsy. Use acetaminophen (Tylenol) to relieve pain.

Although you may have some bruising, there should be no scars left in the breast or on the skin.

Why the test is performed

An ultrasound-guided breast biopsy may be done to evaluate abnormal findings on a mammogram or breast ultrasound, or during a physical exam.

To determine whether someone has breast cancer, a biopsy must be done. Tissue and fluid from the abnormal area are removed and examined under a microscope.

Normal Values

A normal result means there is no sign of cancer or other breast problems.

Your doctor or nurse will let you know if and when you need a follow-up mammogram or other tests.

What abnormal results mean

A biopsy can identify a number of breast conditions that are not cancer or precancer, including:

• Adenofibroma
• Fibrocystic breast disease
• Mammary fat necrosis

Biopsy results may show precancerous breast conditions, such as:

• Atypical ductal hyperplasia
• Atypical lobular hyperplasia
• Intraductal papilloma

Abnormal results may mean that you have breast cancer. Two main types of breast cancer may be found:

• Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
• Lobular carcinoma starts in parts of the breast called lobules, which produce milk.

Depending on the biopsy results, you may need further surgery or treatment.

What the risks are

There is a slight chance of infection at the injection or incision site. Excessive bleeding is rare.

References

Abeloff MD, Wolff AC, Weber BL, et al. Cancer of the breast. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008: chap 95.

Whitman GJ. Ultrasound-guided breast biopsies. Ultrasound Clin. 2006;1:603-615.

Kim CH, Bassett LW. Imaging-guided core needle biopsy of the breast. In: Bassett LW, Jackson VP, Fu KL, Fu YS. Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2005:chap 17.