Breast Biopsies

An ultrasound-guided core biopsy is done with the assistance of sound waves (ultrasound) to locate a suspicious area in the breast and remove tissue samples for further examination and diagnosis. This type of biopsy can answer whether the area of concern contains benign or malignant (cancerous) cells.

One of our Breast Imaging radiologists will perform your biopsy along with a nurse practitioner and a radiology technologist. We often recommend core biopsy over surgery, because it can provide the same information with less discomfort and scarring.

What to Expect

The ultrasound technologist first places a small amount of clear gel on the part of your breast where the biopsy will be performed. The technologist then gently moves the ultrasound transducer over the breast to locate the area in question.

You will receive a local anesthetic to numb the area, and then the radiologist inserts the core needle into your breast where the lump is located.

The core needle has a special edge that is released to collect a core of tissue. This process is usually repeated several times in order to collect multiple samples. The biopsy device does make a snapping noise, which you will hear but should not feel, as the instrument is moved around.

An ultrasound-guided core breast biopsy usually takes just a few minutes to perform.

Biopsy Results

Tissue samples are sent to our breast pathologists for examination and final diagnosis. Results are usually available in five business days and are sent to your referring physician, who will contact you.

If the results indicate breast cancer , an ultrasound-guided core biopsy is considered extremely accurate.

However, certain benign (non-cancerous) pathology results, such as atypical hyperplasia or lobular carcinoma in situ (LCIS), require a surgical biopsy to obtain additional information.

Atypical hyperplasia (abnormal cells in the milk duct) and LCIS (abnormal cells in the milk-producing glands) can be markers for breast cancer risk . Therefore, we advise you to make an appointment with one of our breast specialists here at the BreastCare Center for further evaluation.

Breast cysts or abscesses are typically benign, fluid-filled sacs inside the breast that are sometimes uncomfortable. You may first notice one when you do a breast self-exam and feel a lump. Fine needle aspiration (FNA) is a biopsy procedure that may be done to determine whether the lump in your breast is a cyst or something else.

For a fine needle aspiration, ultrasound is used to locate the area in question. One of our Breast Imaging radiologists, along with a nurse practitioner and radiology technologist, will perform the procedure.

What to Expect

The ultrasound technologist first places a small amount of clear gel on the part of your breast where the biopsy will be performed. The technologist then gently moves the ultrasound transducer over the breast to locate the area in question.

You will receive a local anesthetic to numb the area, and then the radiologist inserts a small, fine needle into the lump and draws out, or aspirates, the fluid.

If the lump is a cyst, the fluid will be clear and you will not need any additional tests. However, if the withdrawn fluid is bloody, it is sent to our breast pathologists for analysis. A small sample of additional cells may also be removed during your biopsy for additional lab tests.

Biopsy Results

Our breast pathologists examine the aspirated fluid (and, if performed, the cell sample) to determine a diagnosis. Biopsy results are generally available within five business days, and are sent to your referring physician, who will contact you.

A follow-up visit is necessary after the aspiration, to make sure the cyst has not refilled with fluid.

A stereotactic core biopsy removes suspicious calcifications  or tissue from the breast for further examination. Both a computer and mammography are used in this type of biopsy to locate the area of concern in the breast.

A stereotactic core breast biopsy is a safe and accurate alternative to a surgical biopsy. The biopsy is performed by one of our Breast Imaging radiologists, along with a nurse practitioner and a radiology technologist.

What to Expect

During the procedure, you will lie face down on a table and place your breast into a round opening in the table. Imaging equipment compresses your breast, just like during a mammogram, to keep it immobile.

The imaging system uses X-ray to create stereo pictures from two different angles. The radiologist can see inside the breast and accurately find the suspicious area.

Once the location is pinpointed, a local anesthetic is used to numb the area. Then a small incision is made in the breast and the core biopsy needle is inserted to take a tissue sample for diagnosis.

Images of the area are taken throughout the biopsy, and you will hear beeping noises from the imaging machines during the procedure — know that this is normal and you should not be alarmed.

A stereotactic core breast biopsy usually lasts between 30 and 60 minutes.

Biopsy Results

Our breast pathologists examine the tissue sample to make a final diagnosis. Results are usually available in five to six business days and are sent to your referring physician, who will contact you.

An MR-guided breast biopsy uses magnetic resonance imaging (magnetic fields) to evaluate breast tissue. Certain tissue characteristics that are not easily seen on ultrasound or mammography can be detected by MRI.

The MR images are used to locate suspicious regions of breast tissue and visually assist in taking samples.

One of our Breast Imaging radiologists will perform your MR-guided biopsy, along with a nurse practitioner and a radiology technologist. This is a less invasive procedure than conventional breast surgery. Since MRI uses magnetic fields to obtain images, there is no radiation exposure.

Preparing for an MR-Guided Breast Biopsy

MRI uses very strong magnets to acquire images. Therefore,

• Tell us if you have a pacemaker, artificial heart valve, aneurysm clips, cochlear implants or other surgical implants.
• Do not wear anything metal on the day of your procedure, including jewelry and hair clips.
• Tell us of any drug allergies you have, as this procedure uses an IV-injected contrast dye. Although unlikely, some patients may have a reaction to the contrast.

What to Expect

First, you will lie on your stomach with your breast suspended through a coil. Your breast will be gently compressed so that images can be obtained. The images will help our radiologist determine where to place the biopsy needle.

Once the area of concern is located, a local anesthetic is used to numb the area before the needle is inserted. Additional images are then be taken to assure that the needle is in the proper location. The radiologist will then obtain the tissue samples.

MR-guided breast biopsies generally take about one hour, but can last longer if more time is needed to acquire the proper imaging.

Biopsy Results

Tissue samples are sent to our breast pathologists for examination and final diagnosis. Results are usually available in five to six business days and are sent to your referring physician, who will contact you.

Sometimes, a diagnosis cannot be made from the tissue removed during an MR-guided biopsy. If this is the case, your health care providers will determine the next step to obtain a diagnosis.