Breast Biopsies

If your physical examination, mammogram or ultrasound yields an abnormal finding, a breast biopsy may be recommended. A breast biopsy is a procedure to collect tiny samples of your breast tissue that will be studied under a microscope. Some biopsies can be performed in a physician’s office, while others need to be done in a hospital setting. This outpatient procedure requires minimal preparation and recovery time. Most biopsies do not result in cancerous findings.

The type of biopsy you undergo depends on many factors and will be decided by you and your physician. It is likely that your procedure will be performed using one of two common imaging systems in breast biopsy, both of which are done at CVMC:

1. Ultrasound-Guided Biopsy
   Ultrasound-guided biopsy uses an instrument that sends out sound waves and a computer to make pictures of the breast lump. A doctor can use this method to guide a needle into very small masses or cysts.
2. Mammogram-Guided Stereotactic Biopsy
   A stereotactic core needle biopsy uses x-ray equipment and a computer to analyze the pictures taken by the x-rays. The computer then pinpoints exactly where in the abnormal area the needle tip needs to go.

Breast Biopsy Procedure

A breast biopsy is performed by your surgeon, who is assisted by a specially trained technologist and nurse.

It is common for you to be in the room for 45-60 minutes.  A family member or friend may wait for you in the Diagnostic Imaging waiting room or other CVMC waiting area.

Before the Procedure

Before the biopsy, follow these and any other guidelines you have been given by your doctor:

• There are no dietary restrictions. You may eat or drink as usual.
• Your doctor will go over your medications with you before the procedure.
• If you are taking aspirin, ibuprofen, an anticoagulant (blood thinner) or certain vitamins, your doctor may instruct you to stop taking them several days prior to the procedure. Bring a list of medications you are currently taking to your biopsy appointment.
• Wear a top that is easily removed and a comfortable bra.
• Do not wear perfume, deodorant, antiperspirant, lotion, powder, or any other substance on your skin.
• Try to empty your bladder before the procedure to help you be more comfortable on the table.

The Biopsy Procedure

The technologist and nurse will give you a thorough explanation of the procedure.  You will undress from the waist up and put on a gown that opens in the front. A technologist and a nurse will stay with you throughout the procedure.

Positioning for a Stereotactic Biopsy:

• You will be asked to lie on your stomach on a special table.

• Your breast is gently placed through an opening in the table.
• Your breast is pressed between two flat plates, similar to a mammogram, so that a low-dose x-ray can be taken. This x-ray helps find the exact tissue to be sampled. Your breast will remain in compression throughout the exam.
• Holding still is very important for the positioning to be effective.

If you have questions or concerns, please contact the Mammography Department at 802-371-4514.

Positioning for an Ultrasound-Guided Biopsy:

In the exam room, you’ll lie on your back on a padded table with one arm raised above your head.

If you have questions or concerns, please contact the Ultrasound Department at 802-371-4487.

During the Biopsy Procedure

After you have been properly positioned for either the stereotactic or ultrasound-guided biopsy, the actual biopsy will consist of the following steps:

• The skin on your breast is cleaned and then numbed with a local anesthetic to make you more comfortable. This will sting slightly and may make you feel jittery.
• A small nick is made in your skin allowing for a thin needle to be inserted.
• The needle is then guided to the biopsy area and used to remove several tiny samples of breast tissue. You should not feel discomfort, only slight pressure.
• A marker may be permanently placed in your breast to allow radiologists and surgeons to identify the biopsy site on future mammograms.  The marker is very small (approximately 4-6 mm) and is typically made of titanium.  Note: The marker poses no health or safety risk and you will not feel or notice it. The marker will not affect security at the airport or a future MRI if needed.
• A mammogram is taken after the stereotactic procedure to ensure the samples are adequate.
• Pressure is applied to your breast for a few minutes. A small bandage is placed over the skin nick and you will be provided with an ice pack to apply over the biopsy site.

After the Procedure

After the biopsy, follow these and any other guidelines you have been given by your doctor:

• Take it easy for 24 hours.
• You will be given instructions on how long to use the ice pack over the biopsy area, when your bandage can be taken off, and when you can take medication (including aspirin) again.
• You may have slight tenderness and/or a bruise for about one to two weeks after the procedure. This is normal. The small nick may cause a tiny scar.
• If you have a fever, excessive bleeding, or other problems, call your surgeon’s office.

Your Test Results

Your surgeon will receive pathology results within 7 to 10 working days and will review the results with you.