What is a needle biopsy of the breast?

Biopsies are the only definitive way to confirm if breast tissue is benign or cancerous. Needle biopsy is a safe, minimally invasive procedure used to get a sample from an abnormal breast lesion. Small amounts of breast tissue are removed through a needle, and the tissue is studied under a microscope by a pathologist, who will then provide a diagnosis.

There are various methods by which a needle biopsy can be performed. An ultrasound-guided biopsy is a technique most often used to guide a breast biopsy when a breast abnormality is visible on ultrasound.

A stereotactic breast biopsy allows for a needle biopsy to be performed on lesions, which are more conspicuous on mammograms than on ultrasound. This type of biopsy utilizes X-ray images (mammograms) of the breast tissue to guide the biopsy needle to the area of interest. Stereotactic biopsies are most commonly performed on breast calcifications, but may also be utilized on breast masses in certain situations.

An MRI-guided breast biopsy is most helpful when MR imaging shows a breast abnormality such as a suspicious mass or area of distortion not identified by other imaging techniques. This type of biopsy uses MRI guidance to calculate the position of the abnormal tissue and to verify the placement of the biopsy needle next to the area of interest.

Ultrasound-guided biopsy

You will lie on your back or turn slightly to the side. The ultrasound probe is used to locate the lesion. Local anesthetic is injected to ensure that you will be comfortable. The radiologist will then create a small nick in the skin through which the biopsy needle will be inserted, and several samples of tissue will be obtained for evaluation. We will provide you with an ice pack and post-biopsy care instructions.

Stereotactic breast biopsy

This minimally invasive procedure is performed in the mammography room. The technologist will assist you into a cushioned chair, which will be adjusted to facilitate the biopsy process, and make you as comfortable as possible. Your breast will then be positioned and compressed similar to your mammogram. Images will be taken to visualize the area to be biopsied. We will then clean the skin and inject a local anesthetic. A tiny incision less than a quarter of an inch is made without causing any significant alteration in the appearance of the breast. The radiologist will remove several samples of tissue through this incision. A small marking clip is left at the biopsy site so that it can be easily relocated for surgery or follow up, if needed. We will provide you with an ice pack and post-biopsy care instructions.

MRI Breast biopsy

During your biopsy, a radiologist will use an MRI scanner to accurately guide a needle to the biopsy site.

A technologist will insert an intravenous (IV) line into a vein in your hand or arm and the contrast material gadolinium will be given intravenously.

You will be asked to lie face down on the scanner table. Your breast will be gently compressed between two compression plates (similar to those used in a diagnostic MRI exam), one of which is marked with a grid structure. Using computer software, the radiologist measures the position of the lesion with respect to the grid and calculates the position and depth of the needle placement.

A local anesthetic will be injected into the breast to numb it. A very small nick is made in the skin at the site where the biopsy needle is to be inserted.

The radiologist then inserts the needle, advances it to the location of the abnormality and MR imaging is performed to verify its position. Tissue samples are then removed. After this sampling, the needle will be removed. A small marker/clip will be placed to mark the area that was biopsied.

Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. This procedure is usually completed within 45 – 60 minutes. You will be taken to Mammography for images to be taken to document the placement of the biopsy clip or marker placed at the end of the MRI biopsy.

After your breast needle biopsy at RCI

After your biopsy, do not participate in any strenuous activity for 24 hours or take aspirin for 48 hours. You will be given an ice pack to place inside of your bra. Apply the ice pack to the biopsy site for 20 minutes every hour for the first 4 hours after the procedure, then as needed to reduce swelling and discomfort. You are also asked to sleep in your bra for the next 2 nights. You may take non-aspirin pain reliver containing acetaminophen (Tylenol) if needed for any discomfort. The Steri-Strips™ may be removed 3 days after the biopsy. You may bathe carefully with the Steri-Strips™ in place, being careful not to loosen them. You may have some discomfort or bruising at the skin incision site. Watch for excessive bleeding, pain or fever. Should any of these occur, contact our office at 319-364-0121.

Biopsy samples are sent to a pathologist, who will analyze and provide your physician and RCI with a diagnosis. You will be notified of results within several days of your biopsy appointment.

For more information on this and other radiology procedures, visit www.radiologyinfo.org.

RCI is accredited by the American College of Radiology (ACR).