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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 29, 2021.

What is a breast biopsy?

If your care team needs to know more about the cells in a breast, a biopsy may be recommended. During a biopsy, a small sample of breast tissue is taken and sent to a lab. There, those cells will be examined under a microscope to see if there’s any sign of disease.

A biopsy can tell your care team more about what’s going on, and it can help them figure out what your next steps should be. Depending on the findings of the biopsy, they may recommend follow-up monitoring, surgery or another treatment.

Biopsies are a common outpatient procedure. In the United States alone, more than one million women have breast biopsies each year.

Your breasts might undergo small changes through your life, or big changes during pregnancy. But some breast changes aren’t normal and might signal a problem.

Your care team may suggest several tests to find out more about your breast changes, but the only definitive way to know if those changes are due to cancer is to get a biopsy.

Abnormal breast changes might include:

  • A lump or firmness in your breast or under your arm
  • Unusual nipple discharge
  • Red, swollen or scaly skin on any area of your breast, including the nipple and the area around it (areola)

If you notice any of these changes, or anything else out of the ordinary, reach out to your doctor. They might start to take a closer look at what’s causing the change by recommending a mammogram, or in some cases an ultrasound or MRI. To get more information, your care team might have to do a second mammogram. If they suspect there may be cancer or need more information, the next step may be a breast biopsy.

Types of breast biopsies

Though there are several different kinds of biopsies, it is often an outpatient procedure – meaning most patients will back at home the same day.

Biopsies can look very different depending on what kind of breast changes you may have—including location and size.

Fine-needle aspiration biopsy

This is a quick procedure that doesn’t require an incision. A very thin and hollow needle is used to take a small amount of tissue and fluid from an area of your breast.

Core needle biopsy

A larger needle is used in a core biopsy. Small pieces of breast tissues, also called “cores,” are removed during this procedure. The care team uses an ultrasound, MRI or mammogram during the biopsy so they can guide the needle precisely where it needs to go. Depending on the imaging procedure used, you may be sitting up or lying on your back or stomach.

There are two types of special core biopsies:

  • A stereotactic core needle biopsy uses the X-rays from a mammography machine to find the abnormal area. The machine will take images from different angles and analyze the results, providing a level of detail that is especially useful for very small abnormal areas.
  • A vacuum-assisted core biopsy takes a sample—or several samples—while your care team uses images to guide the probe. The probe removes a tissue sample using both vacuum suction and a small knife to cut the tissue. Typically, more tissue is removed compared to a standard core needle biopsy.

No matter the type of core needle biopsy, several samples of tissue will likely be taken. A tiny marker, called a clip, may be left in the biopsy area so that your care team can monitor moving forward.

Surgical biopsy

If it’s not clear exactly where the abnormal cells are, you may need to go through one step before the biopsy itself—a “wire localization” or “needle localization”—where a marker is left to let the provider doing the biopsy know exactly where to take tissue from. In this procedure, the care team inserts a small wire while looking at mammogram pictures of the breast to be sure they place the wire precisely in the abnormal area. They’ll leave the wire there for the biopsy, and it will be removed during the biopsy itself. Sometimes newer methods such as radioactive or magnetic markers are placed in the area of concern ahead of time, rather than a wire procedure.

Just like it sounds, a surgical biopsy is more like a surgery—it removes a part or all of a lump. A small cut is made on the skin of the breast, and the surgeon will remove tissue.

There are two types of surgical biopsies:

  • Incisional biopsy: Removes only a part of an abnormal area
  • Excisional biopsy: Removes all of the abnormal area or lump, and some nearby tissue too

Lymph node biopsy

You might have another type of biopsy called a lymph node biopsy if your care team sees a lump under the arm or has any concerns that cancerous cells may have spread. A bit of tissue is removed with a needle, or one or several nodes are removed surgically.

What to expect at your appointment

When you arrive at the appointment, you’ll change into a hospital gown. A health professional will help you get into the right position for the procedure, depending on the type of biopsy being done, and explain what’s going to happen.

Most patients will get anesthesia ahead of the biopsy. Local anesthesia, which makes the area numb, is typically used for a needle biopsy. It also might be paired with conscious sedation or monitored anesthesia, which is IV medication to help a patient relax. For surgical biopsies, it’s more likely general anesthesia and stitches will be used.

In most cases, the pain is minimal and most patients are able to resume normal activities the day after a biopsy. To prevent or reduce breast tenderness, swelling or bruising following the appointment, your care team may send you home with gauze and an ice pack.

How to prepare for your breast biopsy

While a breast biopsy doesn’t require much preparation on your part, there are some things you can do beforehand to minimize the risk of side effects.

  • Stop taking certain medications, such as aspirin or blood thinners, a few days ahead of the procedure
  • Tell your doctor if you have any drug allergies
  • Wear comfortable clothing to the appointment
  • Prepare to have someone else drive you home—especially if sedation or general anesthesia is used
  • Give yourself time after the appointment to decompress

Understanding the results

After the procedure, the biopsy findings will be compiled in a pathology report.

Noncancerous findings

A biopsy might reveal a type of noncancerous breast condition, which often includes lumps or bumps that can be painful at times or noncancerous abnormal cells. While these conditions aren’t cancerous, some of them may increase the risk of breast cancer. Next steps may include regular follow-up screenings, tests or treatment.

Cancerous findings

If the results come back as cancer, your care team will explain what was found, what it means and next steps. More testing may be recommended as well as a referral to more experts in cancer care and treatment.