Regardless of how a lump is detected, the presence of cancer can only be confirmed by a breast biopsy. Biopsies remove a sample of cells or tissue which specially-trained physicians/pathologists examine with a microscope to determine if they are malignant or benign. If cancer cells are present in the tissue, you and your breast specialist team will decide what method of treatment is appropriate for you.
During a surgical biopsy, a surgeon removes part or all of the lump or suspicious area. The tissue is examined by a pathologist checking for cancer cells.
A very thin needle is used to remove fluid, or a small amount of tissue, from the lump. Local anesthetic may or may not be used. The biopsy will determine whether the lump is a cyst filled with fluid, or a solid mass. Clear cyst fluid is not sent to the lab, but any tissue removed through the needle biopsy procedure is sent to the laboratory to be checked for cancer cells. Core Needle Biopsy
: During this procedure a slightly larger needle is used than the fine-needle biopsy to remove several cores of tissue. Ultrasound may be used to direct a needle in the breast if the suspicious area is too small to be felt. Patients receive a local anesthetic and the specimen is examined in the laboratory for cancer cells. Vacuum-Assisted Needle Biopsy
: For this procedure a local anesthetic is used and a small incision is made. A probe is inserted through the incision into the abnormal area of breast. A core of tissue is suctioned into the probe and the tissue sample is cut from the rest of the breast. No stitches are needed and there is minimal scarring. This method usually removes about twice as much tissue as core biopsies. A vacuum-assisted needle can be used with either ultrasound, stereotactic mammographic or MRI guidance. Stereotactic Needle Biopsy
- This biopsy is useful in cases which calcifications or a mass can be seen on the mammogram but cannot be felt. Mammograms are taken from two angles and computers map the exact location of the mass or calcifications. The needle is then placed into or adjacent to a breast mass or calcification cluster to obtain a tissue sample for the biopsy.
It is important to remember each type of biopsy has advantages and disadvantages. What is ideal for one person is not always the right choice for the next. Factors to consider when discussing which biopsy is best for your situation include how suspicious the area appears, the size and number of lesions, where in the breast the lesion(s) is located, and other medical problems you may be experiencing. Be sure to discuss the pros and cons of each viable option with your physician.
Questions to Ask Before a Biopsy
It may help to bring a family member or friend along to help take notes. View a printable list of questions
to ask your doctor. To view and print this list, you will need the Free Adobe Acrobat Reader® software.