BREAST
BIOPSY
BIOPSY
BIOPSY
A Comprehensive Guide to Procedures, Types & Results
Knowledge to Replace Fear with Confidence
A breast biopsy can feel overwhelming, but understanding the process can make all the difference. This page is Dr. Stacy Smith-Foley’s expert guide to you—breaking down biopsy types, the procedure, how to prepare, and what results mean. With over 20 years as a leading Breast Radiologist and Medical Advisor for Learn Look Locate, she’s here to help you feel informed and empowered.
As the founder of Learn Look Locate and a Stage 2B breast cancer survivor, I know how stressful and emotional this experience can be. That’s why I’m honored to share this trusted, physician-led information from Dr. Stacy Smith-Foley so you can approach your biopsy with more understanding and hopefully, a little less anxiety.
- Breast Biopsy Explained: What to Expect and How to Prepare
Dr. Smith-Foley understands how frightening a breast biopsy can be, but it is an important diagnostic tool to identify and treat conditions that affect the breast tissue. She has put together this guide so you can learn more about breast biopsies, understand the different procedures that might be performed, and what to expect. Whether you’re preparing for a biopsy or supporting someone who is, understanding what’s going to happen can reduce anxiety and help you better adapt to the circumstances.
A Breast Biopsy: Facing the Unknown with Support and Knowledge
“The majority of breast biopsies are benign.” Dr. Stacy Smith-Foley
A breast biopsy is a crucial diagnostic procedure that provides definitive answers about breast abnormalities. During this procedure, your doctor removes a small sample of breast tissue or fluid for microscopic examination. While discovering you need a biopsy can be concerning, knowing what to expect can help ease anxiety and prepare you for the process.
- Why You Might Need a Breast Biopsy
- Several findings from routine breast cancer screening might lead your healthcare provider to recommend a biopsy:
- An abnormal mammogram or ultrasound
- A lump discovered during a clinical breast exam
- Changes in breast appearance or texture
- Suspicious nipple discharge
- Concerning findings on breast MRI
- What Your Breast Biopsy Results May Show
Your healthcare team will recommend the most appropriate type of biopsy based on your specific situation.Each type of biopsy has its own benefits and is chosen based on factors like size, location and specific image findings.
“The type of biopsy is chosen based on how the image finding is best detected.”: Dr. Stacy Smith-Foley
Fine-needle aspiration represents the least invasive biopsy option.
Using a very thin needle used to draw blood, your doctor collects cells or fluid from the suspicious area
Your doctor might choose FNA when:
- The area appears to be fluid-filled
- The abnormality is easily accessible.
The procedure typically takes just a few minutes and can often be performed right in your doctor’s office.
Ultrasound Guidance – Real-time ultrasound helps your doctor precisely locate and sample the area of concern. Core needle biopsy play a key role in a definitive diagnosis.
Stereotactic Guidance – Using mammogram, this technique helps target tiny calcium deposits, masses and areas of architectural distortion best seen on mammography.
MRI Guidance – Is used for sampling or targeting areas of increased blood flow that may not be seen well with other imaging methods.
A surgical excisional biopsy removes the entire suspicious area plus a margin of healthy tissue. While less common today, it might be recommended in certain situations. This procedure takes place in a hospital or surgical center under local or general anesthesia.
- The Biopsy Process
Understanding what happens before, during, and after your biopsy can help you feel more prepared and less anxious about the procedure.
Before Your Biopsy
Proper preparation helps ensure a smooth procedure and accurate results. Your healthcare team will provide specific instructions, but general preparation includes:
Medical considerations Your doctor needs to know about:
- All medications you take, including over-the-counter drugs
- Any allergies, especially to anesthesia or adhesives
- Previous breast surgeries or procedures
- Pregnancy or possible pregnancy
- Medical conditions affecting bleeding
Making these simple preparations can help your biopsy go smoothly:
- Wear a comfortable two-piece outfit
- Skip deodorant, powder, or lotion near your breasts
- Eat a light meal before the procedure
- Arrange for transportation if needed
- Bring a supportive friend or family member
Please note that most facilities do not allow support people in the procedure room.
Most breast biopsies follow a similar sequence. First, you’ll be positioned, and the area will be cleaned and numbed. While you might feel some pressure during the procedure, the local anesthetic helps ensure you won’t feel pain.
The most sensitive part of the procedure is the injection of the numbing medication
Your doctor will carefully collect the necessary tissue samples, and may place a tiny marker at the biopsy site. This marker helps identify the area on future mammograms or if additional procedures are needed.
“The majority of my patients say they experience pressure that can be uncomfortable but they not experience pain.” Dr. Stacy Smith-Foley
Most patients return home the same day and can resume normal activities within 24 hours. Your healthcare team will provide specific instructions for caring for the biopsy site.
To help with healing:
- Use ice packs to reduce swelling
- Wear a supportive bra
- Change over the counter medication to Tylenol®
- Keep the area clean and dry
- Understanding Your Breast Biopsy Results: What They Mean and What Comes Next
After your biopsy, a pathologist—a doctor specially trained in examining tissue samples—carefully studies the collected tissue or fluid under a microscope. This detailed examination looks for any abnormal or cancerous cells. While waiting for results can feel challenging, usually taking 2-7 business days, this thorough analysis provides crucial information about your breast health.
The pathology report sent to your doctor contains comprehensive information about the examined tissue. Your healthcare provider will carefully review these findings with you, explaining what they mean for your specific situation.
- What Your Results May Show
Approximately 80% of breast biopsies reveal benign conditions. These findings might include:
- Normal breast tissue changes
- Fibroadenomas-Very common lesions
- Fibrocystic changes
- Simple cysts
- Papillomas –benign growth within a milk duct
- Other non-cancerous growths
Even with benign results, your healthcare provider may recommend follow-up care or monitoring based on your specific situation.
Some types of atypical hyperplasia may be upgraded a cancerous result when removed with surgery. Up to 20% of atypical hyperplasia may be upgraded to malignant. It is the development of precancerous cells within the breast tissues. Generally, this condition is only discovered during a biopsy and causes no symptoms.
The presence of atypical hyperplasia doesn’t mean you have breast cancer, but it does increase your risk of developing it in the future.
“Patients with atypical hyperplasia have a 30% lifetime risk of developing breast cancer.” Dr. Stacy-Smith Foley
If cancer cells are found, the pathology report provides vital information that guides treatment decisions:
For Core-Needle Biopsies:
- The specific type of breast cancer
- Tumor grade (how quickly the cells are growing)
- Hormone receptor status
- HER2 status
- Other characteristics that help determine treatment options
For Surgical Biopsies:
All the above information, plus:
- Margin status (the distance between the cancer and the edge of the removed tissue)
- Size of the tumor
- Whether cancer cells are present in lymph vessels or blood vessels
- Understanding Surgical Biopsy Margins: What They Mean for Your Breast Health
When a surgical biopsy is performed, the pathologist examines the margins—the edges of the removed tissue. Understanding these margins is crucial for determining the next steps in your treatment.
- Types of Margins:
- Negative (clear) margins: No cancer cells found at the edges, suggesting the tumor was completely removed.
- Positive Margins: Cancer cells are present at the edges, indicating the need for further treatment.
- Close Margins: Cancer cells are near the edges (within 3 millimeters), which may require additional procedures.
- What Happens After Your Margin Results:
- Benign Results:
- Your doctor will discuss follow-up care.
- You may return to routine screening.
- Additional monitoring might be recommended depending on your risk factors.
- Malignant Results:
- A consultation with a medical or radiation oncologist is necessary.
- Additional imaging or tests may be ordered.
- Treatment options will be discussed, leading to the development of a personalized care plan.
-
About the Expert
Stacy Smith-Foley
Dr. Smith-Foley emphasizes that breast biopsies, while nerve-wracking, provide crucial information for your breast health. With over 17 years of experience in breast imaging, she notes that advances in technology have made biopsies more precise and comfortable than ever before.
“ Fortunately, I get to give good news more often than I give bad news, so the odds are in your favor. Although I know it’s difficult, try your best to take it one step at a time.”
- Learn Look Locate: Your Partner in Breast Health
At Learn Look Locate, we understand that facing a breast biopsy can be overwhelming. That’s why we’re committed to providing accurate, up-to-date information and support throughout your breast health journey. Our community of survivors, medical experts, and advocates is here to help you navigate this experience with confidence.
Through our educational resources, expert insights, and supportive community, we ensure you have access to the information and support you need. Whether you’re preparing for a biopsy, awaiting results, or seeking to understand your options, Learn Look Locate stands with you every step of the way.
