What Is a Breast Biopsy, and How Is It Performed?

Breast biopsy takes a sample of breast cells or tissue or removes the entire lump. The sample is examined in a laboratory for signs of disease. Biopsy is the only way to determine whether cells are cancerous.

Usually performed as a hospital day procedure, breast biopsies take approximately 10-15 minutes. The person can go home the same day. Local anesthesia means you remain awake without pain. General anesthesia, mainly used for now rarely preferred surgical biopsy, means you sleep throughout.

Biopsy was previously used only to distinguish normal from cancerous tissue. Today, revealing cancer genetics and biology allows prediction of tumor growth rate, metastatic likelihood, effective treatment types (chemotherapy, radiotherapy and so on) and even which drugs will work better.

What Types of Breast Biopsy Exist?

• Fine needle biopsy:
  Fine needle aspiration is a simple procedure lasting minutes. A thin needle collects fluid and cells. It drains and samples fluid-filled lesions called cysts. It is not normally preferred for sampling suspicious breast lumps.
• Core needle (trucut) biopsy:
  A needle takes rice-grain-sized tissue samples. Under local anesthesia and ultrasound guidance, it is a painless procedure completed within minutes. After observation, the patient may be discharged. It is comfortable, highly diagnostic and extremely low risk. Mild bruising may occur, but no scar. It is the most preferred breast biopsy method.
• Vacuum-assisted biopsy:
  A probe attached to a vacuum device collects tissue. The incision is much smaller than for surgical biopsy, leaving little scar and requiring no stitches.
• Surgical biopsy:
  Also called excisional biopsy, it removes part or all of a lump for laboratory cancer assessment. Sometimes used first, it may also follow insufficient needle biopsy. Sampling only breast tissue is incisional biopsy; removing the entire lump or suspicious area is excisional biopsy. We now rarely prefer this method.

Who Performs Breast Biopsy?

Image-guided biopsy is performed by interventional radiologists , physicians trained and experienced in ultrasound (USG), tomography and magnetic resonance (MR), identifying diseased areas and reaching them with needles.