I Need a Breast Biopsy, How Is It Done?

Updated on January 27, 2014
C.B. asks from unknown city, unknown state
11 answers

I was asked to come back for a second mammogram a week after my yearly check. At the end of the 2nd appointment the radiologist showed me an area of calcification that he recommended I get biopsied. I was told 80% of these types of findings on mammogram images turn out to be benign. I will call the surgeon on Monday and schedule the biopsy but wanted to ask you ladies how exactly is a breast biopsy done? Do they use local anesthesia and a big needle? Or is there general anesthesia and cutting? How did you feel afterward? Was there pain or just discomfort? Should I be asking questions that I am not even aware of? Any and all information would be helpful and appreciated.

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So What Happened?

On Friday I had a Stereotactic Core Biopsy: similar to a mammogram but seated, my breast was numbed with a progressively deeper shot (the stuff in the shot stung a bit). Once my breast was numb and squashed into position, several views were taken to find where they should guide the needles. A robot uses a kind of gatling-gun arrangement of needles to take multiple (5 I believe) "cores" of tissue about 3mm by 10mm, leaving a nice circle of holes. Those cores will be sent out for pathology and on Thursday I will hear results. About 80% are benign, another 10% "atypical" and for both these categories I will require mammograms at 6 month intervals for a while to observe any changes. The final 10% can be either "cancer in situ" (meaning it has not spread anywhere) or full blown breast cancer (spread outside the calcification areas). Since no lumps can be felt it is unlikely I will fall in the latter category. Aftercare is tylenol only since other pain killer thin the blood and can cause bleeding, wearing a bra to bed to prevent the cut to bleed, and neopsorin and a bandaid. The waiting for results is all that is left. Thanks all of you ladies for your information and support. I will post results once I know.

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K.W.

answers from Seattle on

I had a needle biopsy. They use local anesthetic and ultrasound to guide the needle. It was really easy and quick. I got it done in the morning and then drove straight to work. Minimal pain. Good luck!

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A.M.

answers from Washington DC on

There are multiple types.
I've had needle aspirations which was inserting a needle and then pulling back the plunger in an attempt to check for fluid in a lump. A little cream was used to numb the area first. Took a few minutes.
I've had punch biopsies where there was a small incision, then a piece of tissue is cut from the lump. I got local anesthesia for that. Held together afterwards with surgical tape and went back to work (except the time that I had multiple ones in a single day). Sore for a few days.
I've had surgical biopsies where a larger incision is made, the entire lump (ans sometimes surrounding tissue is removed), and then the area is stitched. Versed for the awake version and once they knocked me out. This one hurts and I couldn't return to work until the next day.
Good luck!

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S.S.

answers from Chicago on

I have had 2 different kinds of Breast Biopsies. The first was just a regular Biopsy in the doctors office. My best friend went with me. And I would suggest that if you can take someone with you to hold your hand. Not because of the pain involved which wasn't much but because it is so much easier to do with someone holding tight to you while it is happening. The first biopsy I had was just the needle kind. Dr just put the needle in (looked like the needles they use to give you a shot) and sucked some stuff out. I did have a very small bruise afterwards. It wasn't nearly as traumatic as I thought it was going to be. in my case it was positive for breast cancer. I had a mastectomy done and the breast removed.

The next one I had was a needle guided biopsy in the other breast. There were spots on the mammogram. The mammogram and ultra sounds showed it but without confirmation from a biopsy they didn't know if it was the same thing or just really dense tissue. So I had to go to the hospital and they have a special mri machine for breast mri's and they have to use that machine to do the needle guided biopsies. numbinb creme and a shot in the general area. That test was also not nearly as scary or painful as I anticipated. The dr sang me christmas carols lol. kept me laughing off and on throughout it. that one took about a half hour. I did have little surgical tapes holding the incisions together. Like a previous poster said you can drive etc. your awake throughout. Good luck. I have a said a prayer for your and that your doctors be skillful.

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D..

answers from Miami on

I can't answer your question, but just want to tell you that we'll all be thinking of you! Best of luck that you are in that 80% (great odds!)!

Big hugs~~

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A.M.

answers from Dallas on

I had a similar situation and just wanted to let you know not to worry too much. The procedure for me was painless but took a couple hours. They spend a lot of time positioning you in the right position in the machine. Once the nurse finally feels like you are in the right position, the doctor comes in to check it and make further adjustments. Once the procedure starts they give you a local anesthetic (hard to remember but I believe it was a cream followed by a shot). You are wide awake, but can't see much. Once it starts, the doctor guides the machine and the biopsy is over within 5 minutes. I don't remember feeling anything. You can drive afterward, it is not a big procedure. Good luck and please, don't worry unless and until there is a reason to worry!

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D.B.

answers from Boston on

Sorry you're going through this - I used to have a lot of questionable mammograms and I understand the anxiety you feel wondering what's to come. Women with dense breasts or fibrocystic breasts often get these recommendations when a section of the mammogram comes out either cloudy, dark or showing small spots of calcification.

I've had both a stereo needle biopsy (2 penetrations, very local anesthesia) - in my case, I was lying down on a table with a hole in it, and my one breast was hanging down through the hole so they could get to the correct location. Mostly so annoying on the one shoulder I was lying on so they could get me in the right position. I really couldn't see anything that was being done, although I'm not all that squeamish about anything medical. But if you are, there's no need to watch! There were no stitches, and just ice to avoid swelling, and as-needed meds for the discomfort. I drove myself there, and drove myself home afterwards just to keep some ice on the area (it would've looked funny at work with a big old ice pack in there, but in terms of how I felt, I could certainly have gone back.) The worst part is the waiting around for the appointment, the correct positioning and the results.

I also had an excision biopsy, which is surgery - a section of tissue which contained all the calcifications was excised, and analyzed by pathology. This is sometimes done when there are a number of small things to be looked at which cannot be obtained accurately with just an aspiration or suction of the section (as is done with cysts, for example). I had a series of mammograms in the pre-op area so they could insert a very small, thin wire and be sure the end was in the area of the calcifications. (You might now have that - it depends on where in the breast the problem is located. I'm just sharing what happened for me.)

Then I had general anesthesia, the surgeon made a small incision, and removed the tissue around the end of the wire, ensuring that he had the right area. This did require some stitches afterwards. The anesthesia takes a while to wear off (you wake up, but then a few hours later there's a bit of a rebound, so you definitely sleep it off for the rest of the day and then take the next day to do pretty much nothing. So you really sleep through most of the initial pain. I had prescription pain meds for a day, then just over the counter meds. I wanted to be very careful about not pulling the stitches at all because I didn't want to have to go back in, and I didn't want to create a larger scar. There is a small and very thin scar about 1.5 inches long on the side of my breast, not noticeable really and causing absolutely no pain or problem. They gave me some advice about when to start wearing a bra again, but that varies by patient and where the incision is.

Since then, I've been able to reduce the cysts in my breasts and I've never had another questionable mammogram, biopsy or surgery. That takes away a lot of the worry and the hassle!

But I agree that the vast majority of these suspicious mammograms turn out to be benign, and it's better to get checked out and not postpone.

As others have said, a lot depends on where in the breast this is, and what the best method is to get to it. It's not a bad idea to take someone with you to the appointment with your list of questions and a pad of paper to take down any notes while you're busy listening. It's easy to forget things. But don't hesitate to call back and talk to the nurse, PA or surgeon if you have questions after you get home. During the preparation on the day of the biopsy, I also found the various assistants to be very helpful, reassuring and comforting.

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M.T.

answers from New York on

You really need to find out what type of biopsy you are having - aspiration type, core needle, surgical? There are different kinds, and each is different. Please be sure to call and ask what type of biopsy you are having and what it will involve.

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T.F.

answers from Dallas on

I've not been in your situation and have no words except I will keep you in my thoughts that we will get a great report from you afterwards!!

Big hugs to you!!

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S.S.

answers from Chicago on

I've had them twice and both times I went to the hospital and they did give me anesthesia and they guided a needle into me while they projected the image on a screen. I was pretty nosey and asked most of the time (when it appeared safe) what they were doing and they were pretty nice. I was absolutely terrified the second time because I actually previously had uterine cancer and was fearful of another cancer. It turned out it was a tiny teensy cyst which was fine and not cancerous. The only after affect was a swollen breast LOL as if I needed that and a little bruising. The whole idea can be terrifying but they are doing it to protect us. And men can have this happen, too, so we can all remind men in life that if they are suspicious or their doctors of anything to take care of it! Saying superprayers all goes well for you. HUG

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S.W.

answers from Amarillo on

I agree with Diane B. I had both done at different times. The needle biopsy was done without anesthesia and I did not feel it. I had a grid like pattern placed on the breast in question before the needle was inserted so that they knew where to go inside. The other was done under sedation where a portion of the nipple and the area in question were removed. I later had a lumpectomy done to remove the area in question. Thank you goes to my doctor for the marvelous job he did. There is no outward scarring all I have is a small dimple where the tissue was removed.

I am surprised that the doctor's office did not make the appointment for the next medical step.

Think positive about the biopsy. You will have to wait for the results before you go to your next step. Just take it one day at a time. Keep yourself busy until you know the results. Worrying does not help you physically.

You will be in my thoughts. Do keep us posted on the outcome. I have been a breast cancer survivor for 17 years this September. Post me if you have more questions.

the other S.

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D.K.

answers from Pittsburgh on

I had a surgical biopsy with a local. A friend had a needle biopsy (actually multiple needles with MRI guidance). Both of us were back at work the next day. My surgeon had frozen sections cut immediately so I knew the lesion was benign before I went home that afternoon. My friend's surgeon did not and she waited 2 weeks for her results (also fine) Best of luck, the procedures themselves are not biggies. I would not have general anesthesia if I could avoid it.

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