Breast biopsy - ultrasound
Biopsy - breast - ultrasound; Ultrasound-guided breast biopsy; Core needle breast biopsy - ultrasound; Breast cancer - breast biopsy - ultrasound; Abnormal mammogram - breast biopsy - ultrasound
A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders.
There are several types of breast biopsies, including stereotactic, ultrasound-guided, MRI-guided, and excisional breast biopsy. This article focuses on needle-based, ultrasound-guided breast biopsies.
Of all the different types of cancers, breast cancer is one of the most talked about, and with good reason. One out of every eight women will develop breast cancer sometime in their life. That's why every woman should be thinking about how to protect herself from this disease. Breast cancer is cancer that forms in the breast. Usually, it begins in the tubes that transport milk from the breast to the nipple. If the cancer spreads to other parts of the breast or body, it's called invasive breast cancer. Some breast cancers are more aggressive, growing more quickly than others. Although women are 100 times more likely to develop breast cancer, men can also get the disease because they do have breast tissue. You're more likely to get breast cancer if you're over 50, you started your periods before age 12, or you have a close family member with the disease. Drinking more than a couple of glasses of alcohol a day and using hormone replacement therapy for several years also may increase your risk. The telltale sign of breast cancer is a lump in your breast or armpit. You may also notice a change in the shape, size, or texture of your breast, or have fluid coming from your nipple when you're not breastfeeding. If you notice any changes in your breasts, call your doctor. You'll probably need to have an imaging scan, such as a mammogram, MRI, or ultrasound. A piece of tissue may be removed from your breast, called a biopsy. With these tests, your doctor can tell whether you have breast cancer, and if so, determine whether or not it has spread. So, how do we treat breast cancer? That really depends on the type of cancer, and how quickly it's spreading. Your doctor may recommend that you have the cancer removed with surgery. Sometimes it's enough just to remove the lump. That's called a lumpectomy. In other cases, the doctor will need to remove the entire breast to get rid of all the cancer or prevent it from coming back. That's called a mastectomy. Other treatments for breast cancer include chemotherapy, medicines that kill cancer cells, and radiation therapy, which uses energy to destroy cancer. Women whose cancer is fueled by the hormone estrogen may receive hormone therapy to block the effects of estrogen on their cancer. Today's breast cancer treatments are better than ever. Many women who have breast cancer go on to live long, healthy lives. The outlook really depends on how fast the tumor is growing, and how far it has spread. That's why it's so important to report any changes in your breasts to your doctor as soon as you notice them. Women who are at an especially high risk for breast cancer because of their family history can talk to their doctor about taking medicine or even having surgery to reduce their risk.
How the Test is Performed
You are asked to undress from the waist up. You wear a robe that opens in the front. During the biopsy, you are awake.
You lie on your back.
The biopsy is done in the following way:
- The health care provider cleans the area on your breast.
- Numbing medicine is injected.
- The doctor makes a very small cut on your breast over the area that needs to be biopsied.
- The doctor uses an ultrasound machine to guide the needle to the abnormal area in your breast that needs to be biopsied.
- Several small pieces of tissue are taken.
- A small metal clip may be placed into the breast in the area of the biopsy to mark it, if needed.
The biopsy is done using one of the following:
- Fine needle aspiration
- Hollow needle (called a core needle)
- Vacuum-powered device
- Both a hollow needle and vacuum-powered device
Once the tissue sample has been taken, the needle is removed. Ice and pressure are applied to the site to stop any bleeding. A bandage is applied to absorb any fluid. You do not need any stitches after the needle is taken out. If needed, strips of tape may be placed to close the wound.
How to Prepare for the Test
The provider will ask about your medical history and may perform a manual breast exam.
If you take blood thinning medicines (including aspirin, supplements, or herbs), ask your doctor whether you need to stop taking these before the biopsy.
Tell your doctor if you may be pregnant.
Do not use lotion, perfume, powder, or deodorant underneath your arms or on your breasts.
How the Test will Feel
When the numbing medicine is injected, it may sting a bit.
During the procedure, you may feel slight discomfort or light pressure.
After the test, the breast may be sore and tender to the touch for several days. You will be given instructions about what activities you can do, how to take care of your breast, and what medicines you can take for pain.
You may have some bruising, and there will be a very small scar where the needle was inserted.
Why the Test is Performed
An ultrasound-guided breast biopsy may be done to evaluate abnormal findings on a mammogram, breast ultrasound, or MRI.
To determine whether someone has breast cancer, a biopsy must be done. Tissue from the abnormal area is removed and examined under a microscope.
A normal result means there is no sign of cancer or other breast problems.
Your provider will let you know if and when you need a follow-up ultrasound, mammogram or other tests.
What Abnormal Results Mean
A biopsy can identify a number of breast conditions that are not cancer or precancer, including:
- Fibroadenoma (breast lump that usually isn't cancer)
- Fat necrosis
Biopsy results may show abnormal conditions such as:
- Atypical ductal hyperplasia
- Atypical lobular hyperplasia
- Flat epithelial atypia
- Intraductal papilloma
- Lobular carcinoma-in-situ
- Radial scar
- Fibroepithelial lesion
- Mucocele-like lesion
If the biopsy result is benign, you may not need any further treatment, though sometimes surgery to remove a benign condition is recommended. If the biopsy shows an abnormal condition, you may be referred to a surgeon to discuss a surgical biopsy to remove the entire area and test it more thoroughly.
Depending on surgical biopsy results, you may need further surgery or treatment.
Your provider will discuss the meaning of the biopsy results with you.
There is a slight chance of infection at the injection or incision site. Excessive bleeding is rare.
American College of Radiology website. ACR practice parameter for the performance of ultrasound-guided percutaneous breast interventional procedures.
Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Cancer of the breast. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 88.
Thigpen DM, Huppe AI, Mehta AK, Brem RF. Breast biopsy and ablation. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, eds. Image-Guided Interventions. 3rd ed. Philadelphia, PA: Elsevier; 2021:chap 105.
Last reviewed on: 3/15/2021
Reviewed by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.