Biopsy

Biopsy

A biopsy is done when mammograms, other imaging tests, or the physical exam finds a
breast change (or abnormality) that is possibly cancer. A biopsy is the only way to tell if
cancer is really present.
During a biopsy, a sample of the suspicious area is removed to be looked at under a
microscope, by a specialized doctor with many years of training called a pathologist. The
pathologist sends your doctor a report that gives a diagnosis for each sample taken.
Information in this report will be used to help manage your care. For information to help
you understand your pathology report, see Breast Pathology or call 1-800-227-2345.
There are several types of biopsies, such as fine needle aspiration biopsy, core (large
needle) biopsy, and surgical biopsy. Each has its pros and cons. The choice of which to
use depends on your specific situation. Some of the factors your doctor will consider
include how suspicious the lesion appears, how large it is, where in the breast it is
located, how many lesions are present, other medical problems you might have, and your
personal preferences. You might want to discuss the pros and cons of different biopsy
types with your doctor.
Fine needle aspiration biopsy
In a fine needle aspiration (FNA) biopsy, the doctor uses a very thin, hollow needle
attached to a syringe to withdraw (aspirate) a small amount of tissue from a suspicious
area, which is then looked at under a microscope. The needle used for an FNA biopsy is
thinner than the ones used for blood tests.
If the area to be biopsied can be felt, the needle can be guided into the area of the breast
change while the doctor is feeling (palpating) it.
If the lump can't be felt easily, the doctor might use ultrasound to watch the needle on a
screen as it moves toward and into the mass.
A local anesthetic (numbing medicine) may or may not be used. Because such a thin
needle is used for the biopsy, the process of getting the anesthetic may actually be more
uncomfortable than the biopsy itself.

Once the needle is in place, fluid is drawn out. If the fluid is clear, the lump is probably a
benign cyst. Bloody or cloudy fluid can mean either a benign cyst or, very rarely, a
cancer. If the lump is solid, small tissue fragments are drawn out. A pathologist will look
at the biopsy tissue or fluid under a microscope to determine if it is cancerous.
An FNA biopsy is the easiest type of biopsy to have, but it has some disadvantages. It can
sometimes miss a cancer if the needle is not placed among the cancer cells. And even if
cancer cells are found, it is usually not possible to determine if the cancer is invasive. In
some cases there may not be enough cells to perform some of the other lab tests that are
routinely done on breast cancer specimens. If the FNA biopsy does not provide a clear
diagnosis, or your doctor is still suspicious, a second biopsy or a different type of biopsy
should be done.