A breast biopsy is the removal of a suspicious sample of breast tissue to check for the presence of abnormal, or cancerous, cells. Your healthcare provider may recommend a breast biopsy if you have changes in your mammogram, ultrasound or breast exam. Depending on the circumstances, a breast biopsy can be done in a healthcare provider's office, an ambulatory facility or a hospital. There are various methods that may use ultrasound, mammography or other imaging techniques to help identify the area to be biopsied.
- Needle biopsy - The surgeon removes tissue through a small needle (aspiration biopsy) or a hollow needle (punch biopsy). Occasionally a vacuum-type device is used to pull out the breast tissue. A needle biopsy is done through a small hole made in the skin, so there is less chance of infection or scarring. However, the results may not be as accurate because it is possible to miss cancerous cells.
- Incisional biopsy - The surgeon makes an incision and removes a piece of breast tissue. Sutures are usually needed to close the incision. There is a greater chance of infection or scarring. However, the results are typically more accurate because there is less of a chance the surgeon will miss cancerous cells.
- Lumpectomy - The surgeon makes an incision and removes about a quarter of the breast. Depending on the circumstances, additional tissue around the lump may also be removed. A medication is injected into the area to numb it prior to the biopsy. Sutures are usually needed to close the incision.
There are many factors that increase your chance of getting breast cancer. These risks factors can be divided into those that you cannot control and those that you can control or eliminate. Some of the uncontrollable risks factors for breast cancer include:
- Age - You have a higher risk as you age.
- Sex - Although men can get breast cancer, women have a much higher risk.
- Family history - A close family member had cancer of the breast, uterus, ovary or colon.
- Menstrual cycle - You started your period before you were twelve or went through menopause after you were fifty-five. This is thought to be due to prolonged estrogen exposure.
- Genetics - You have a defect in the BRCA1 or BRCA2 gene. These genes produce a protein that helps protect the body from cancer. Only about one percent of women with strong family histories of breast and ovarian cancer have this gene.
Some of the controllable risks factors for breast cancer include:
- Alcohol use - The risk increases as more alcohol is consumed.
- Childbirth - You have never had children or you had your first child after the age of thirty. Women that have more than one child may have a decreased risk of breast cancer.
- DES exposure - You were given diethylstilbestrol (DES) to prevent a miscarriage.
- Hormone therapy - You have taken estrogen replacement therapy (HRT) for many years.
- Obesity - You are obese. Some have noted that fat cells produce more estrogen, which increases the growth of certain types of breast cancer.
- Radiation - You underwent radiation treatment, especially if you received the radiation as a child or young adult.
FYI: There are no conclusive links between breast cancer and underwire bras, antiperspirant or breast implants.
Things you can do to decrease your risk of developing breast cancer, or catch it at a very early (curable) stage, include:
- Screening mammograms as recommended by your healthcare provider.
- Make lifestyle changes that include limiting your alcohol intake, exercising regularly, eating a healthy diet and maintaining a healthy weight.
- Discuss the pros and cons of hormone therapy after menopause, genetic testing, preventive medications and preventive surgeries with your healthcare provider.
It is important you are aware of how your breasts normally look and feel. There are frequently no symptoms in the early stages of breast cancer. Symptoms that require medical attention include:
- A lump in the breast or armpit
- A change in the appearance of the breast or nipple (redness, dimples or puckering)
- Bloody, clear, yellow or green discharge from the nipple
Contact your healthcare provider if you have any of the symptoms noted above. He or she will perform a physical examination of your breasts, underarms, neck and chest. They may also recommend one of the following tests:
- Mammography to screen for and evaluate breasts lumps
- MRI of the breast to screen women at high risk or evaluate an abnormality in the breast
- Ultrasound of the breast to determine if a lump is solid or filled with fluid
- Removal of tissue for examination under a microscope (biopsy)
A biopsy is needed to determine if a lump or other abnormality is cancer. If your breast biopsy indicates you do have breast cancer, additional testing will most likely be needed.
If your healthcare provider recommends a breast biopsy, prior to the procedure tell them about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before and after the procedure. These include:
- Medications you should not take before the procedure, such as blood thinners
- Regular medications you should continue to take on the day of your procedure
- How many hours you should stop eating and drinking before the procedure
Contact your healthcare provider if you have symptoms of breast cancer. Be prepared to discuss your symptoms and how long you've had them.
- Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
- Make a list of your medications (including over-the-counter).
- Write down any questions, symptoms or concerns you want to talk about.
- If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).
What should I ask my healthcare provider before having a breast biopsy?
- What is my diagnosis and reason for the surgery? Are there any alternatives? What are the benefits and risks of each?
- What are the possible complications for this surgery?
- What happens if I don't go through with the surgery?
- What is your experience in doing this type of surgery? What is your complication rate?
- Is there any special preparation for the surgery? (If so, get clear instructions on what you need to do.)
- Will I need anesthesia? What are the possible side effects?
- How will I feel after the surgery? Will I have to modify my activity?
After your surgery, you should know what you had done, what medication was given and what symptoms you should report to your healthcare provider after discharge. You should also understand all home care instructions (including medications and side effects) and follow-up plans.
- Your surgeon should also communicate with your primary care physician.
- Don't forget to make arrangements for transportation to and from the facility and help at home.