South Sound Radiology > Services > Breast Health

Breast Biopsy

Lumps or abnormalities in the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not always possible to tell from these imaging tests whether a growth is benign or cancerous.

A breast biopsy is performed to remove some cells—either surgically or through a less invasive procedure involving a hollow needle—from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. Image-guided needle biopsy is not designed to remove the entire lesion, but most of a very small lesion may be removed in the process of biopsy.

Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by hand (called palpation).

Stereotactic Breast Biopsy
Exam & Prep

Stereotactic Breast Biopsy is a simple and safe procedure performed in our office on an outpatient basis. Advanced digital imaging technology is used to map the precise location of the area of concern in your breast. This technology allows the Radiologist to remove small needle core samples of the suspicious tissue with pinpoint accuracy. The samples are sent to a pathologist, who specializes in the microscopic analysis of tissue for the purpose of diagnosis.

PRIOR TO YOUR EXAM:

Discuss any medication you are taking with your physician. You will be asked to discontinue the use of blood-thinning medications, including aspirin and aspirin-like products, prior to your biopsy procedure. If you are taking medications such as heparin, coumadin, Warfarin, or Plavix you will need to check with your doctor who prescribed them about discontinuing their use prior to an after the biopsy day.
Wear clothing that is comfortable and easy to remove from the waist up. A gown will be provided for your use.
Do not use deodorant, underarm powders or creams before the procedure. They may interfere with the quality of the images taken during your procedure.
Eat a light meal before your procedure. Limit your liquids, so that you do not have to use the restroom during the procedure.
Most patients are able to drive themselves to and from this appointment, but some prefer to have a friend or relative accompany them to their appointment.

THE DAY OF YOUR EXAM:

At the time of your appointment, you will be assisted to a dressing room and provided with a gown and asked to remove your clothing from the waist up.
A female technologist will position you face down on a specially designed table with your breast placed through an opening in the tabletop. The tabletop will be raised, and the Radiologist and technologist will perform the procedure from beneath the table.
Your breast will be compressed and held in a fixed position to ensure the accuracy of the procedure. X-ray images will be taken, and special computer software will map the exact location where tissue samples will be taken. The skin over the biopsy area will be cleansed and numbed with a local anesthetic injected into the breast with a small, thin needle. A tiny skin nick will be made just large enough for the biopsy needle to pass through as the tissue samples are taken. You may feel some slight pressure and tugging. Several needle core tissue samples are taken to ensure the most accurate diagnosis possible.
When the procedure is completed, a sterile bandage will be applied over the skin nick. You will be asked to wear a soft supportive bra for 24 hours following the procedure and to apply ice packs intermittently throughout the rest of the day to minimize swelling and bleeding. Stitches are not required for this procedure.
You should plan on being at our office for about two hours, although the actual biopsy will take approximately one hour. Once you receive instructions concerning the care of the biopsied area, you will be free to dress and leave. You will need to avoid strenuous activity and heavy lifting for 24 hours. Remain off blood thinning medications for 48 hours. You may experience some discomfort and notice some bruising in the biopsied area. This usually disappears within five to seven days and is a normal part of the healing process.

Ultrasound Guided Breast Biopsy
Exam & Prep

If an abnormality is clearly visible with the use of Ultrasound, a biopsy can be performed using ultrasound guidance.

PRIOR TO YOUR EXAM:

Discuss any medication you are taking with your physician. You will be asked to discontinue the use of blood-thinning medications, including aspirin and aspirin-like products, prior to your biopsy procedure. If you are taking medications such as heparin, coumadin, Warfarin, or Plavix you will need to check with your doctor who prescribed them about discontinuing their use prior to an after the biopsy day.
Wear clothing that is comfortable and easy to remove from the waist up. A gown will be provided for your use.
Do not use deodorant, underarm powders or creams before the procedure. They may interfere with the quality of the images taken during your procedure.
Eat a light meal before your procedure. Limit your liquids, so that you do not have to use the restroom during the procedure.
Most patients are able to drive themselves to and from this appointment, but some prefer to have a friend or relative accompany them to their appointment.

THE DAY OF YOUR EXAM:

At the time of your appointment, you will be escorted to a dressing room, provided with a gown, and asked to remove your clothing from the waist up.
A technologist will position you comfortably on your back on the ultrasound bed.
The skin over the area of concern will be cleansed and a local anesthetic administered to numb the area.
A tiny nick is made in the skin and the radiologist will insert the biopsy needle into the breast under Ultrasound guidance. You may experience a sensation of pressure at this point but should not experience any pain.
Several biopsy specimens are obtained of the abnormal breast tissue. The specimens will be sent to the pathologist for diagnosis.
After the procedure, a sterile bandage will be applied over the biopsy site. No stitches are required. Most patients experience minimal if any discomfort or bruising following this procedure, but we still request that you refrain from strenuous activity for 24 hours.
Although the biopsy portion of the procedure is about 30 minutes, you should plan on being at our office for about one and a half hours.

MRI-Guided Breast Biopsy
Exam & Prep

MRI-guided breast biopsies use magnetic resonance imaging to guide the Radiologist to the site of the breast abnormality.

PRIOR TO YOUR EXAM:

Discuss any medication you are taking with your physician. You will be asked to discontinue the use of blood-thinning medications, including aspirin and aspirin-like products, prior to your biopsy procedure. If you are taking medications such as heparin, coumadin, Warfarin, or Plavix you will need to check with your doctor who prescribed them about discontinuing their use prior to an after the biopsy day.
Wear clothing that is METAL FREE, comfortable, and easy to remove from the waist up. A gown will be provided for your use.
Do not use deodorant, underarm powders or creams before the procedure. They may interfere with the quality of the images taken during your procedure.
Eat a light meal before your procedure. Limit your liquids, so that you do not have to use the restroom during the procedure.
Most patients are able to drive themselves to and from this appointment, but some prefer to have a friend or relative accompany them to their appointment.

THE DAY OF YOUR EXAM:

At the time of your appointment, you will be assisted to a dressing room. A gown will be provided for your use.
You will need to remove all metal objects before you are scanned, including jewelry, hairpins, glasses, clothes with zippers, keys, etc. The magnet will erase any credit cards.
You will be positioned face down on a moveable exam table and the affected breast or breasts will be positioned into openings in the table. 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. This is similar to a regular breast MRI.
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 for needle placement.
After injecting a local anesthetic 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 guides the needle to the location of the abnormality and MR imaging is performed to verify the needle position.
Tissue samples are then removed using a vacuum-assisted device. Vacuum pressure is used to pull tissue from the breast into the sampling chamber of the biopsy needle. Typically, 8 to 10 samples of tissue are collected.
After the core samples have been obtained, a small marker may be placed within the breast at the biopsy site so the area can be located in the future if necessary.
Once the biopsy is complete, a small bandage is placed over the skin nick. No sutures are required. This procedure is usually completed within 45 minutes to one hour.
Afterwards, a 2-view mammogram will be taken.