Breast Biopsy
What is a Breast Biopsy?
Should a breast lesion that appears irregular, lobulated or spiculated be detected in your breast, the next step is to rule out malignancy. A biopsy is done by taking a small sample of tissue or cells to be evaluated under a microscope in a laboratory.
The type of biopsy performed depends on several factors, including the position of the lesion, its size and shape, and the number of abnormalities present.
The radiologist may recommend a fine needle aspiration biopsy (FNA) or core or stereotactic biopsy based on how the lesion is categorised.
The benefits of a biopsy compared to surgical intervention include a minimally invasive procedure that only requires local anaesthesia, the ability to perform an outpatient procedure, fewer complications, and less pain/bleeding/scarring.
A surgical biopsy is required should the minimally invasive biopsy provide inconclusive results.
What happens before the procedure?
You will be explained the procedure and asked to sign informed consent. Please ask your referring physician, radiologist, or mammographer if you have any questions.
Recent blood results, clotting factors, and all prior imaging should be available before the procedure commences.
Fine needle aspiration biopsy (FNAB): Body fluid and cells are aspirated via a needle and syringe. FNA is recommended for cysts, solid lumps or enlarged lymph nodes. FNA is done under ultrasound guidance.
Core needle biopsy: This procedure is routinely performed and is a minimally invasive technique. The procedure involves collecting a larger sample of tissue than a FNAB. A larger needle is used to obtain a more adequate specimen, and at least 3 (three) core samples are needed to assess the lesion. (Ultrasound guidance)
Stereotactic biopsy: This technique is used when a lesion is not palpable and cannot be visualised on ultrasound but can be seen on the mammogram. Biopsies are recommended for suspicious calcifications and deep lesions. (Mammographic guidance)
What are possible complications?
Infection and abscess formation; Bleeding and bruising; Damage to underlying structures, e.g. large blood vessels
What can you expect during the procedure?
The radiologist will clean the affected side, injecting a local anaesthetic to numb the area. This will ensure that the procedure is as painless and comfortable as possible.
The radiologist and radiographer will prepare all the necessary equipment for the procedure in a sterile manner. The appropriate needle size will be used depending on the type of biopsy performed. A sample will be removed from the lesion, and the biopsy site will be cleaned and covered with a dressing.
You will be monitored, and you may leave the department as soon as all imaging is completed and you are comfortable.
What to expect after the biopsy?
You may experience some discomfort or tenderness after the procedure. Pain relief medication may be recommended (Do not take Aspirin – it might encourage bleeding). The discomfort and tenderness may last a few days but should not cause long-term effects. If the pain worsens, please contact your physician.
Do not swim or take a bath for a week after the biopsy. Showering is allowed. Intermitted cooling with a wrapped ice pack is advised to decrease bruising and pain.
What about the result?
The specimen is sent to a pathology laboratory for analysis, and the results will be forwarded to your referring physician. Please discuss your results with your physician.