Jackson Surgical Associates

Percutaneous Biopsy

This less-invasive type of breast lump biopsy uses needles or special probes to remove samples through the skin. In most cases, these biopsies can be done in a doctor’s office or in an outpatient setting. If a lump cannot be felt, an image-guided biopsy is done.

Fine needle aspiration is the simplest type of biopsy. It can be used to sample cells of lumps that can be felt, both fluid-filled cysts and solid masses. This type of biopsy needs no anesthesia.

• Before the procedure, your healthcare provider will talk with you about the minor risks of this procedure. You may have a little bleeding, pain, or bruising where the needle is inserted.
• This simple biopsy takes just minutes to perform. A very thin needle is placed into the lump. Fluid is sampled, or cells are removed if the lump is solid. Cells from a solid mass are checked in a lab. Clear fluid from a cyst may be discarded.
• After the biopsy, any bruising or pain should go away quickly, and you will not have a scar. You should receive your test results in just a few days. Be sure to discuss them with your healthcare provider. Sometimes an aspiration gives a false negative result. This means you may have cancer cells that do not appear in the biopsy sample. If the results are not clear, you are likely to have another type of biopsy.

Core needle biopsy provides a larger cell sample than fine needle aspiration. A core needle can be used for solid masses that you can feel. It can also be used for breast changes that cannot be felt. Once removed, the biopsy samples are sent to the lab.

• Before the biopsy, tell your healthcare provider about medications, vitamins, or herbs that you take. He or she will also talk with you about what to expect after the biopsy. You are likely to have some bruising and swelling. There is also a small chance of infection at the site where the needle is removed.
• During the biopsy, you will be given a local anesthetic so you are awake but pain-free. The doctor then uses a hollow needle to remove a section of the mass or breast change. More than one biopsy sample may be taken. The needle may be inserted more than once.
• You can go home shortly after the biopsy. You may have a small bandage, but stitches are not likely. A small, freckle-like scar may form at the biopsy site. Be sure to discuss your results with your healthcare provider. In some cases, a biopsy may give a false negative result (cancer cells may exist, but not appear in the biopsy sample). If the results are not clear, you are likely to have another type of biopsy.

Image-guided biopsy is used if a lump or breast change cannot be felt. In such cases, breast changes are pinpointed with the help of computer-mapping guided by mammograms.

Breast changes can also be located using sound waves. Once located, the tissue samples may be taken using a core needle. Sometimes a vacuum-assisted probe is used instead. This experience is similar to that of a core needle biopsy, but the probe usually is inserted only once.

Call the doctor who performed your biopsy if you have:

• A fever over 101
• Bloody drainage that lasts for days
• Increased pain, warmth, or redness at the incision site

Surgical Biopsy

A surgical breast lump biopsy allows for a larger sample of tissue to be removed. In fact, the whole lump is often taken out.

If a breast change is due to microcalcifications (tiny deposits of calcium), tissue-containing calcifications are removed. The lump or tissue sample is then sent to a lab.

There, the sample is checked under a microscope. Most surgical biopsies are done in a hospital or clinic on an outpatient basis.

Before the biopsy, tell the surgeon about any medications, vitamins, or herbs you take. This includes aspirin and any other over-the-counter drugs. Some may affect your body’s response during the biopsy. Others may affect your healing afterward. The day of your biopsy, wear a loose shirt that buttons in front. Also, be sure to arrange for a trusted adult to take you home.

Sometimes, a breast change that cannot be felt is hard to locate. In such a case, one or more guide wires may be placed in the breast right before biopsy surgery. These thin wires help mark the tissue that is to be removed.

A mammogram or ultrasound is used to direct the wire’s placement. First the breast area is numbed, then the wire is inserted with a needle. After this, you will be taken to the operating room for the biopsy. The wire is removed during this procedure.

• During the biopsy, you may be given intravenous sedation. This produces a light sleep. The surgeon then makes one incision in your breast. If possible, this will be done in a way that hides the scar. In most cases, the lump is completely removed. The incision is then closed with stitches. Some stitches dissolve on their own. Others need to be taken out later.
• You can go home the day of the biopsy. In most cases, you will not be too uncomfortable. But your surgeon may prescribe pain medications just in case you need them. Ice packs can also help ease soreness and swelling. Leave the dressing on as long as your healthcare provider instructs. Also, follow his or her advice about bathing and exercise.

Call your surgeon if you have any of the following:

• A fever over 101
• Bleeding that soaks through the dressing
• Cough, chest pain, or shortness of breath
• Increased pain, warmth, or redness at the incision site
• Pus draining from the incision site
• Severe swelling or bloody drainage that doesn’t go away in a few days