What is a Breast Biopsy? This is a minimally invasive outpatient procedure which allows you to return to your normal activities within a few hours after the completion of the exam. It is usually ordered by your doctor if any abnormalities are detected in your physical exams, mammograms, ultrasound or special view mammography. If a biopsy is indicated, you can have a mammogram or an ultrasound guided fine needle or core biopsy to ascertain whether a malignancy (cancer) is present.

Today many suspicious breast abnormalities can be diagnosed without surgery by using needle biopsy. In the past, excisional surgery biopsy was the only option for this purpose. There are two types of needle biopsies - fine needle aspiration biopsy (FNAB) and core needle biopsy (CNB). FNAB uses a very thin needle to remove fluid and tiny fragments of tissue. CNB uses a slightly larger needle to remove a cylindrical piece of tissue about 1/16 inch in diameter and 2 inches long. Core needle biopsy is the preferred method because FNAB is difficult due to the small amount of tissue extracted maybe inadequate.

But, even if an abnormality is too small to be felt, FNAB or CNB can still be done using breast imaging methods such as ultrasound and stereotactic mammography to guide the needle into the lesion. During an ultrasound examination, the physician can view the needle on a screen as it moves toward and into the mass.
What is a Stereotactic Needle Biopsy?
Stereotactic needle biopsy is a method that is useful in some cases in which calcifications or a mass can be seen on a mammogram but cannot be located by touch. Based on mammograms taken from two angles, computerized equipment maps the precise location of the mass or calcifications. The computer guides the placement of the needle for CNB or, less often, FNAB.

Wire localization is a procedure used to guide a surgical (excisional) breast biopsy of a small lump that is difficult to locate by touch or of areas that look suspicious on the x-ray (due to calcifications, for example) but do not have a distinct lump. After numbing the area with local anesthetic, a hollow needle, thinner than that used for drawing blood, is placed into the breast and x-ray pictures are taken to guide the needle to the suspicious area. A thin wire is inserted through the center of the needle. A small hook at the end of the wire keeps it in place. The hollow needle is then removed, and the surgeon uses the wire as a guide to locate the abnormal area to be removed.

The choice of which type of biopsy to use depends on each patient's situation and needs. Some of the factors to consider include how suspicious the lesion appears, how large it is, where in the breast it is located, how many lesions are present, other medical problems the patient may have, and personal preferences. Patients are encouraged to discuss the advantages and disadvantages of different biopsy types with their doctors.