What is a Breast Biopsy?

Once a breast lump or breast abnormality has been detected, your doctor may want to conduct a breast biopsy. This procedure involves taking sample tissue from the suspicious area to determine whether the breast lump is cancerous or benign.
While the thought of having a breast biopsy might be frightening, the results can provide reassuring peace of mind. Remember, the vast majority of breast biopsies do not turn out to be breast cancer. And a biopsy is currently the only way to achieve an accurate diagnosis.

Breast Biopsy Options

The past decade has seen dramatic improvements in breast biopsies, giving physicians and patients new choices in breast biopsy procedures. Most women can now receive an accurate breast biopsy diagnosis without the need for an open surgical procedure.

Knowing your options and discussing them with your doctor can help you gain a definitive diagnosis while minimizing pain, scarring and recovery time.

Breast Biopsy Comparison Chart


Mammotome Breast Biopsy Devices

In a biopsy performed with a minimally invasive Mammotome vacuum-assisted breast biopsy device, a small probe is inserted into the breast through an incision about the size of a match head. Vacuum is used to gently draw, cut and collect tissue in the probe’s hollow chamber. This biopsy technique enables several samples to be acquired, resulting in a highly accurate breast cancer diagnosis. Since multiple tissue samples are obtained without removing and reinserting the probe, there is less internal scarring, which minimizes interference with future monitoring and diagnosis of breast abnormalities.

Following a breast biopsy, the patient is typically sent home with a small adhesive bandage to cover the incision. The breast biopsy can be completed in less than one hour and is performed in an outpatient setting or doctor’s office without general anesthesia or stitches.

Core Needle Biopsy

In a core needle biopsy, the physician makes a small skin incision through which a needle is inserted into the lesion to obtain sample tissue. The hollow spring-loaded device is “fired” repeatedly into the abnormality to collect a sufficient amount of breast tissue for analysis. Usually, 4 to 6 samples are taken (4 to 6 insertions). This biopsy procedure is performed in an outpatient setting or doctor’s office without general anesthesia or stitches.

Open Surgical Biopsy

Open surgical biopsy is an accurate procedure; however, it is the most invasive biopsy procedure and often results in both external and internal scarring. Most patients recover quickly from breast biopsy surgery, although some may experience post-operative pain or minor disfiguring of the breast. This is considered general surgery, which requires an operating room, general anesthesia (in some cases), and stitches. Because of the hospital and surgical resources needed to perform the operation, open surgical biopsies are more costly than other breast biopsy methods. Because most breast biopsies are for small breast abnormalities that cannot be felt (non-palpable lesions), open surgical biopsies are sometimes viewed as excessive.

Open surgical procedures often involve a two-step process. First, a radiologist identifies the area to be biopsied. Through a process known as wire localization, a wire is positioned in the abnormal breast tissue to identify the area to be cut out and removed during the breast biopsy surgery. Next, the patient is taken to the operating room where she is placed under general anesthesia or a local anesthesia with sedation. A surgeon makes a 1 to 2-inch incision in the breast and removes the localization wire and a large section of tissue, typically about the size of a golf ball. The incision in the breast is then closed with stitches and covered with a protective bandage.

Fine Needle Aspiration

Fine Needle Aspiration (FNA) is a biopsy procedure that uses a thin needle on a syringe to draw fluid and/or cellular material from a breast abnormality. Thus, Fine Needle Aspiration provides information about cellular material, whereas the three biopsy procedures discussed above allow tissue within the abnormality to be compared to surrounding tissue for a more accurate diagnosis. Fine Needle Aspiration is most often used to aspirate, or drain fluid, from benign (non-cancerous) fluid-filled cysts. The extracted fluid can then be examined by a pathologist to confirm whether the abnormality is benign or requires further testing.

Fine Needle Aspiration biopsy procedures are generally performed by a physician in his or her office. If the breast lump is small and cannot be felt, the procedure can be performed using stereotactic or ultrasound imaging guidance. During the procedure, a long, thin needle is inserted through the breast into the abnormality for sample extraction. Because the needles used for Fine Needle Aspiration biopsies are smaller than needles used to draw blood, local anesthesia is not required.

If the breast abnormality turns out to be solid or the fluid collected looks suspicious, your doctor will likely recommend an additional biopsy. The larger samples collected through other biopsy methods allow tissue within the abnormality to be compared to surrounding tissue for a more accurate diagnosis.

Image Guidance

Minimally invasive biopsies, such as those conducted with Mammotome biopsy devices, core needle biopsy, and fine needle aspiration (FNA), use computer-generated images to locate breast abnormalities. By accurately pinpointing and mapping the area to be biopsied, physicians can gather tissue samples (or cellular material) without making large incisions.

There are three methods used for producing images in minimally invasive breast biopsies: stereotactic x-ray, ultrasound, and magnetic resonance (MR) imaging. Stereotactic biopsies use mammography (x-rays); ultrasound biopsies use high-frequency sound waves; and MR biopsies use powerful magnets and radio waves to locate breast abnormalities.

Stereotactic Biopsies

In a minimally invasive breast biopsy using stereotactic imaging, a patient lies face down on a special table with her breast protruding through a hole in the table’s surface. The breast is lightly compressed to immobilize it throughout the biopsy procedure. The table is connected to a computer that produces detailed x-ray images of the abnormality to be biopsied. Using these images, the doctor guides a special sampling device (for example, a Mammotome biopsy probe) to collect tissue specimens.

Ultrasound Biopsies

Minimally invasive breast biopsies using ultrasound imaging are performed on patients in an upright or reclined position. Using a hand-held transducer, a doctor will move the device back and forth across the breast to generate clear images of the abnormal breast tissue. While viewing the images on a computer monitor, the doctor will guide a small probe into the breast to retrieve sample tissue specimens.

MRI Biopsies

Breast MRI biopsies differ only slightly from traditional needle biopsies. Although the needle looks the same, it is specialized and made of a different material, such as titanium, so it is compatible with MRI and can be used in an MRI suite.

The increased ability to detect cancerous breast lesions with MRI and biopsy them during the test is especially valuable for patients at high risk for breast cancer.


Talk to Your Doctor

If a breast biopsy using a minimally-invasive vacuum-assisted device, such as Mammotome’s devices, has fewer risks and is just as reliable as surgery, why hasn’t your doctor mentioned it?

This could be for a variety of reasons. Your doctor may not be familiar with Mammotome’s breast biopsy devices or may not know the location of the nearest breast biopsy facility that uses Mammotome’s devices. If your doctor performs biopsies, he or she may not have the equipment and training needed to conduct a breast biopsy using Mammotome’s devices.

By talking with your doctor, you can fully explore your options and find out if a biopsy using one of Mammotome’s minimally invasive vacuum-assisted breast biopsy devices is right for you.