This page was reviewed under our medical and editorial policy by
Daniel Liu, MD, Plastic and Reconstructive Surgeon.
This page was reviewed on February 8, 2022.
If your care team needs to know more about the cells in a breast, a biopsy may be recommended. During a biopsy, a small sample of breast tissue is taken and sent to a lab. There, those cells will be examined under a microscope to see if there’s any sign of disease.
A biopsy can tell your care team more about what’s going on, and it can help them figure out what your next steps should be. Depending on the findings of the biopsy, they may recommend follow-up monitoring, surgery or another treatment.
Biopsies are a common outpatient procedure. In the United States alone, more than one million women have breast biopsies each year. About 20 percent of the breast biopsies performed result in a breast cancer diagnosis.
Your breasts might undergo small changes through your life, or big changes during pregnancy. But some breast changes aren’t normal and might signal a problem.
Your care team may suggest several tests to find out more about your breast changes, but the only definitive way to know if those changes are due to cancer is to get a biopsy.
Abnormal breast changes might include:
If you notice any of these changes, or anything else out of the ordinary, reach out to your doctor. They might start to take a closer look at what’s causing the change by recommending a mammogram, or in some cases an ultrasound or MRI. To get more information, your care team might have to do a second mammogram. If they suspect there may be cancer or need more information, the next step may be a breast biopsy.
Though there are several different kinds of biopsies, it is often an outpatient procedure – meaning most patients will back at home the same day.
Biopsies can look very different depending on what kind of breast changes you may have—including location and size.
A fine-needle aspiration biopsy is a quick procedure that doesn’t require an incision. A very thin and hollow needle is used to take a small amount of tissue and fluid from an area of your breast.
A larger needle is used in a core needle biopsy. Small pieces of breast tissues, also called “cores,” are removed during this procedure. The care team uses an ultrasound, MRI or mammogram during the biopsy so they can guide the needle precisely where it needs to go. Depending on the imaging procedure used, you may be sitting up or lying on your back or stomach.
There are two types of special core biopsies:
No matter the type of core needle biopsy, several samples of tissue will likely be taken. A tiny marker, called a clip, may be left in the biopsy area so that your care team can monitor moving forward.
If it’s not clear exactly where the abnormal cells are, you may need to go through one step before the biopsy itself—a “wire localization” or “needle localization”—where a marker is left to let the provider doing the biopsy know exactly where to take tissue from. In this procedure, the care team inserts a small wire while looking at mammogram pictures of the breast to be sure they place the wire precisely in the abnormal area. They’ll leave the wire there for the biopsy, and it will be removed during the biopsy itself. Sometimes newer methods such as radioactive or magnetic markers are placed in the area of concern ahead of time, rather than a wire procedure.
Just like it sounds, a surgical biopsy is more like a surgery—it removes a part or all of a lump. A small cut is made on the skin of the breast, and the surgeon will remove tissue.
There are two types of surgical biopsies:
You might have another type of biopsy called a lymph node biopsy if your care team sees a lump under the arm or has any concerns that cancerous cells may have spread. A bit of tissue is removed with a needle to help inform treatment decisions. A sentinel lymph node biopsy is often combined with breast cancer surgery, during which one or several whole lymph nodes are removed.
While a breast biopsy doesn’t require much preparation on your part, there are some things you can do beforehand to minimize the risk of side effects.
When you arrive for your procedure, you’ll change into a hospital gown. A health professional will help you get into the right position for the procedure, depending on the type of biopsy being done, and explain what’s going to happen.
Most patients will get anesthesia ahead of the biopsy. Local anesthesia, which makes the area numb, is typically used for a needle biopsy. It also might be paired with conscious sedation or monitored anesthesia, which is IV medication to help a patient relax. For surgical biopsies, it’s more likely general anesthesia and stitches will be used. A biopsy may take as little as 20 minutes or an hour or more depending on what type of procedure is performed, how many samples are needed and if anesthesia is required.
Recovery from a breast biopsy may often depend on the type of procedure performed. Patients may experience some pain or tenderness for a few days after the procedure. In most cases, the pain is minimal and most patients are able to resume normal activities a day or two after a biopsy. To prevent or reduce breast tenderness, swelling or bruising following the appointment, your care team may send you home with gauze and an ice pack.
After the procedure, the biopsy findings will be compiled in a pathology report.
A biopsy might reveal a type of noncancerous breast condition, which often includes lumps or bumps that can be painful at times or noncancerous abnormal cells. While these conditions aren’t cancerous, some of them may increase the risk of breast cancer. Next steps may include regular follow-up screenings, tests or treatment.
If the results come back as cancer, your care team will explain what was found, what it means and next steps. More testing may be recommended as well as a referral to more experts in cancer care and treatment.