A biopsy is done when mammograms, other imaging tests or the physical exam find a breast change (or abnormality) that is possibly cancer. A biopsy is the only way to tell if cancer is really present. Just because you have a biopsy does not mean you have breast cancer.

During a biopsy, a sample of the suspicious area is removed to be looked at under a microscope by a specialized doctor with many years of training called a pathologist. The pathologist sends your doctor a report that gives a diagnosis for each sample taken. Information in this report will be used to help manage your care.

There are several types of biopsies:

• Fine needle aspiration biopsy - A thin needle, thinner than needles used for blood tests, is inserted into a lump and removes a sample of cells of fluid.
• Core (needle) biopsy - A needle with a special tip is used to remove a sample of breast tissue about the size of a grain of rice.
• Vacuum-assisted core biopsy - This biopsy is performed with a probe that uses a gentle vacuum to remove a small sample of breast tissue.
• Surgical biopsy - A small incision is made in the skin and breast tissue to remove all or part of a lump.
• Lymph node biopsy - a lymph node biopsy is done at the time of a needle biopsy

The choice of which biopsy to use depends on your specific situation. Some of the factors your doctor will consider include how suspicious the lesion appears, how large it is, where in the breast it is located and how it is best visualized on imaging, how many lesions are present, other medical problems you might have, and your personal preferences. You might want to discuss the pros and cons of different biopsy types with your doctor.

If needed, ultrasound mammography or MRI may be used to guide the biopsy needle. Your doctor may use a computer to locate the exact spot for the biopsy sample from mammograms that have been taken from two angles.

Often, after the tissue sample is removed, the doctor will place a fine wire or tiny metal clip as a marker inside the breast at the biopsy site. The marker cannot be felt and should not cause any problems, but it is helpful in finding the area again on future mammograms and for surgery. Some patients who have cancer are given chemotherapy or other treatments before surgery that can shrink the tumor so much that it can't be felt or seen on mammogram. The clip can be used to direct the surgeon to the area where the tumor was so the correct area of the breast can be removed.

The Health First Breast Center offers patients a range of minimally invasive biopsy options.