Needle Breast Biopsy

Needle breast biopsies are done by putting a needle or probe through the skin of the breast. A tissue sample is then removed for testing. This type of biopsy can be done in a healthcare provider’s office or in an outpatient setting. The needle or special probe is put through the skin of the breast to remove tissue samples that might be cancer. In some cases, a tiny cut (incision) is made in the skin over the changed breast tissue or lump. Once removed, the biopsy sample is sent to a lab for study.

If a lump or breast change can't be felt, an image-guided biopsy is done. In these cases, the breast change may be located using ultrasound guidance. Computer mapping, based on mammograms, can also help pinpoint breast changes and guide the needle to the right place. The type of breast biopsy done depends on the following:

• The size of the lump or breast change

• Where it is located in the breast 

• How much the lump or breast change looks like cancer

• Other health problems you may have

• Your preferences

Talk with your healthcare provider about the pros and cons of the type of biopsy that's best for you. Also talk about what you can expect during and after the biopsy.  

Understanding the risks

Before the biopsy, your healthcare provider will talk with you about the risks of the procedure:

• There may be slight bruising or bleeding where the needle or probe is put through the skin.

• There's a small risk of infection.

• All needle biopsies may provide a false-negative result. This means you may have cancer cells that don’t show up in the biopsy sample. If the results aren’t clear, you will likely need to have another type of biopsy. Often this other biopsy will be one that removes more tissue.

During the biopsy

Needle biopsies are usually done under local anesthesia. This means medicines are used to numb the area of the breast that the needle will be put into. There are several types of needle breast biopsy procedures. The type of biopsy done will depend on the location and size of the breast lump or change. Here are brief descriptions of the most common types:

• Fine needle aspiration (FNA). A very thin, hollow needle is placed into the lump. Tissue or fluid is pulled into the needle. No cut is needed. This type of biopsy takes only minutes to perform.

• Core needle biopsy. A larger needle is used to take out small cylinders or cores of tissue. The needle is inserted for each sample, and several samples are taken. A tool called a biopsy gun may be used to move the needle in and out of the lump quickly. No cut is needed.

• Vacuum-assisted biopsy. The tube-like probe often is inserted only once. The breast tissue is gently suctioned into the tube. A small rotating knife inside the tube removes the tissue. A small cut in the skin may be needed to put in the larger, hollow probe.

When needed, any of these biopsies can be image-guided. This means an ultrasound or some other kind of imaging test is used to guide the needle to the area of concern.

After the biopsy

You can go home shortly after the biopsy, no matter which method is used. And you can return to your normal routine almost right away. You may have some bruising and swelling for a few days. Be sure you know what the signs of problems are and when to call your healthcare provider. Sometimes a small, freckle-like scar appears.

Ask your healthcare provider when you can expect your biopsy results and how you will get them.