Breast Biopsy Options

You will be offered several options for diagnosis and treatment of your breast problem. Recommendations will be made and you will be able to decide what works best for you.

If you have noticed a lump or other change in your breast, your doctor may recommend several tests to determine if you have cancer. After taking your medical history and performing a manual breast exam, your doctor may recommend a breast x-ray or mammogram, ultrasound, and/or MRI. You may be asked to have a combination of these tests. If the lump is suspected to be a cyst, your doctor may use a needle to drain fluid from the lump.

The Biopsy Procedure

Another test is a biopsy where tissue is removed and a pathologist examines it under a microscope. The mass or a portion of it is removed under local or monitored anesthesia. Biopsy is the only certain way to diagnose breast cancer.Minimally invasive core biopsies using mammography and ultrasound to guide the procedure have become the standard of care when it is technically feasible. Complete surgical excision biopsy may be recommended if the mass is located in a part of the breast that makes this the best option for diagnosis or if the lump cannot be seen on mammogram or ultrasound.

During the biopsy procedure, the surgeon removes the suspicious tissue to see if it is benign or malignant. If it is malignant, the pathologist will try to identify the type of cancer cells present, how fast they reproduce, if the blood vessels or lymph systems contain cancer cells, and if the cancer's growth is affected by hormones. This information allows your doctor to determine the best treatment for you.

There are two ways a pathologist prepares the tissue for examination:

A "frozen section," which is a quick procedure that takes about 30 minutes

A "permanent section," which takes 2 to 3 days.