Need to Know
Nice to Know
Frequently Asked Questions
Why is This Exam Done?
Ultrasound-guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast that are visible on ultrasound, whether or not they can be felt on breast self-examination or clinical examination. The procedure prevents the need to remove tissue surgically and also eliminates the radiation exposure that comes from using x-rays to locate a mass.
What Will Happen During the Exam?
You will be positioned lying face up on the examination table or turned slightly to the side. The radiologist will locate the lesion by scanning your breast with the ultrasound transducer/probe. Once the area is located, the radiologist will clean the area with a cleansing anteceptic, then numb your skin and the interior breast with a local anesthetic. This may cause a slight sting but the area will become numb within a short time. A very small nick is made in the skin and you may feel some pressure when the biopsy needle is inserted. If discomfort is experienced, the radiologist can administer additional anesthetic. The radiologist will constantly monitor the lesion site with the ultrasound transducer/probe and will advance the needle directly into the mass. Tissue samples are then removed from the area by filling a needle trough, or shallow receptacle, with ‘cores’ (small samples) of breast tissue. The outer sheath instantly moves forward to cut the tissue and places the sample in the trough. As each sample is taken,clicking noise will be heard. The needle remains in the breast as the trough is removed to dislodge the samples and returned for three to six cores.
When sampling is completed the needle will be removed from the breast and a small marker (clip) may be placed at the site so that it can be located in the future if necessary. This marker cannot be felt, does not cause pain and will not interfere with any surveillance (metal detector).
Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed. A mammogram may be performed to confirm that the marker is in the proper position. The tissue samples will be sent to the pathology laboratory for analysis with the results returned within 2-3 days.
How Should I Prepare?
- There are no diet restrictions, eat and drink as usual
- You may perform normal daily activities prior to the procedure
- Take usual medications on exam day
- Aspirin and anticoagulants increase the risk of bleeding and bruising.Patients taking anticoagulants (blood-thinners) or aspirin should contact the doctor managing those medications to see if they can safely stop them prior to the biopsy
- Herbal substances that affect bleeding, such as Gingko biloba, should be stopped prior to the breast biopsy
- You may want to have ice packs readily available at home for any initial swelling
What Are the Benefits and Risks?
The benefits of Breast Biopsy (Fine Needle Aspiration):
- The procedure is less invasive than surgical biopsy, leaves little or no scarring and can be performed in less than an hour
- Ultrasound imaging uses no ionizing radiation
- Ultrasound-guided breast biopsy reliably provides tissue samples that can show whether a breast lump is benign or malignant
- Ultrasound-guided breast biopsy is able to evaluate lumps under the arm or near the chest wall, which are hard to reach with stereotactic biopsy
Risks you should be aware of:
- Hematoma, or a collection of blood at the biopsy site can occur. Less than one percent of patients.
- Infection – Any procedure where the skin is penetrated carries a risk of infection. However, the risk is minimal and affects less than 1 in 1,000 patients.