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Breast Biopsies Explained: Types, Pain Management, Procedures, and More

by Dr. Charles H. Weaver, M.D., Medical Oncologist, Medical Advisor, Learn Look Locate.

A breast biopsy is a crucial medical procedure for diagnosing breast changes, potentially indicating cancer. This guide aims to provide comprehensive insights into the various aspects of breast biopsies, addressing common concerns and incorporating recent research and trends.

When and Why Are Breast Biopsies Recommended?

A breast biopsy is typically recommended if you develop a lump in your breast or experience other breast changes. The biopsy helps determine whether these changes are due to breast cancer or a benign condition. Understanding the different types of breast biopsies, such as core needle biopsy, fine needle aspiration, and vacuum-assisted biopsy, is essential for informed decision-making.

Types of Breast Biopsies

Breast biopsy types range from less invasive needle biopsies to more comprehensive surgical biopsies. Your doctor will recommend the most suitable type based on factors like the location and size of the suspicious area, your overall health, and personal preference.

Needle Biopsies:

  • Core Needle Biopsy: Involves using a hollow needle to remove a small tissue sample.
  • Fine Needle Aspiration: Uses a thinner needle to remove a few cells.
  • Vacuum-Assisted Biopsy: Utilizes a thicker needle with a vacuum-assisted probe, often guided by ultrasound or mammography.

Surgical Biopsies:

  • Excisional Biopsy: This involves the removal of the entire lump along with some surrounding tissue. It’s more invasive but offers a comprehensive analysis.

Breast Biopsy Procedure and Pain Management

The biopsy procedure varies depending on the type of biopsy. Needle biopsies are usually quick, performed under local anesthesia, and involve minimal discomfort. Surgical biopsies, while more extensive, are conducted under anesthesia to ensure patient comfort. Pain management during and after the procedure is a crucial aspect, with most patients experiencing minimal to moderate discomfort.

Advantages and Disadvantages

Each biopsy type has its pros and cons. Needle biopsies are less invasive and have quicker recovery times but may sometimes require follow-up procedures if results are inconclusive. Surgical biopsies provide more comprehensive results and may eliminate the need for additional surgery but involve greater risks like infection and noticeable scarring.

What to Discuss with Your Doctor

Before undergoing a biopsy, it’s essential to discuss the details with your doctor, including the procedure’s length, recovery time, scarring, potential side effects, and when to expect results. This information can help alleviate anxiety and prepare you for the procedure.

The Role of Pathologists in Breast Biopsies

During the biopsy, a pathologist examines the tissue sample under a microscope, looking for cancer signs. Advanced techniques like NGS biomarker testing may also be used to identify specific cancer-driving mutations, offering insights into targeted treatment options. To learn more about Pathology, click here.

The Choice Between Open and Needle Biopsy

The choice between an open surgical breast biopsy and a needle breast biopsy depends on various factors, including the lump’s location and the patient’s medical history. While needle biopsies are less invasive and typically preferred, open biopsies may be necessary in certain circumstances.

Reducing Anxiety During Breast Biopsy

Managing anxiety and discomfort during a biopsy is crucial. Techniques like meditation have shown promising results in reducing anxiety and pain during the procedure, making it a more bearable experience for many women.

Fast Facts and Statistics

  • Approximately 1.6 million women undergo breast biopsies annually.
  • Needle biopsies are considered the gold standard, with accuracy rates equal to open surgical biopsies but lower costs and risks.
  • Only 15-20% of abnormalities detected by mammography are cancerous, underscoring the importance of biopsies for accurate diagnosis.

Breast biopsies are a vital tool in the early detection and diagnosis of breast cancer. Understanding the different types of biopsies, their procedures, and the importance of discussing options with your healthcare provider can significantly impact your healthcare journey. With advancements in technology and techniques, the process of undergoing a breast biopsy has become more precise and patient-friendly.

About Dr. C.H. Weaver, M.D.

Dr. Charles Weaver is a Medical Oncologist, and the founder and editor of CancerConnect. After training at University of Pennsylvania, Fred Hutchinson Cancer Center and The National Institute of Health Dr Weaver founded CancerConnect with the goal of providing information and support to cancer patients and their caregivers. He has published in the New England Journal of Medicine, Blood, Journal of Clinical Oncology and has authored over 9000 articles for patients on the management of cancer.

The article was originally published on Cancer Connect. Modified on 11/2023 with author permission.

  • Edge S, Ottesen R, Lepisto E, et al. Surgical biopsy to diagnose breast cancer adversely affects outcomes of breast cancer care; finding from the National Comprehensive Cancer Network. Proceedings from the 28th annual San Antonio Breast Cancer Symposium.