Biopsy Breast

Indications for Breast Biopsy

A breast biopsy involves removing a sample of breast tissue to determine whether it is cancerous or benign (non-cancerous). While physical breast exam, mammography, ultrasound, and other breast imaging methods can help detect a breast abnormality, biopsy followed by pathological (microscopic) analysis is the only definitive way to determine if cancer is present.

Breast Biopsy Overview

A breast biopsy involves removing a sample of breast tissue to determine whether it is cancerous or benign (non-cancerous). There are several different types of breast biopsy. the location of the abnormality in the breast and in relation to other anatomic structures

the number of abnormalities detected during physical examination or with x-ray imaging

Many biopsy methods rely on image guidance to help the radiologist or breast surgeon precisely locate the lesion (abnormality) within the breast. Imaging may be necessary when a lesion (breast abnormality) cannot be felt during examination and is only detected on imaging studies such as mammography or ultrasound. Biopsy methods that may require image guidance include:

fine needle aspiration biopsy (FNA)

core needle biopsy

vacuum-assisted biopsy (Mammotome or MIBB)

large core biopsy (ABBI)

open surgical biopsy (excisional or incisional)

Of these methods, FNA, core needle, and vacuum-assisted biopsies are performed as percutaneous ("through the skin") procedures rather than surgical biopsies. Click on one of the biopsy methods listed above for a detailed explanation of the procedure.

Digital Spot-View Mammography Improves Breast Biopsy

Digital spot view mammography is often used during breast biopsy and typically allows a faster and more accurate stereotactic biopsy. With digital spot-view mammography, images are acquired digitally and displayed immediately on the system monitor. Traditional stereotactic biopsy requires a mammogram film be exposed, developed and then reviewed, significantly increasing the time before the breast biopsy can be completed. Today, the majority of facilities use digital mammography when image guidance is needed for stereotactic biopsy.

What is Stereotactic (Mammographically Guided) Breast Biopsy?

Lumps or abnormalities in the breast are often detected by physical examination, mammography, or other imaging studies. Image-guided needle biopsy is not designed to remove the entire lesion, but most of a very small lesion may be removed in the process of biopsy.

Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by hand (called palpation).

In stereotactic breast biopsy, a special mammography machine uses ionizing radiation to help guide the radiologist’s instruments to the site of the abnormal growth.

How is the procedure performed?

Image-guided, minimally invasive procedures such as stereotactic breast biopsy are most often performed by a specially trained radiologist.

Breast biopsies are usually done on an outpatient basis.

The breast is compressed and held in position throughout the procedure.

Several stereotactic pairs of x-ray images are taken.

X-ray images are again obtained to confirm that the needle tip is actually within the lesion.

Tissue samples are then removed using one of two methods.

In a core needle biopsy, the automated mechanism is activated, moving the needle forward and filling the needle trough, or shallow receptacle, with ‘cores’ of breast tissue. With a vacuum-assisted device (VAD), vacuum pressure is used to pull tissue from the breast through the needle into the sampling chamber. After the sampling, the needle will be removed.