A doctor may recommend a biopsy to investigate a breast lump. The type of biopsy a person has depends on the nature of the lump. Biopsies may cause some discomfort and bruising.
A breast biopsy is a simple procedure in which a doctor removes a small sample of tissue from a lump in the breast to send to a laboratory for testing. A doctor may perform a biopsy on breast tissue to determine whether a lump in the breast is cancerous or benign.
In this article, we look at the purpose of a biopsy for breast cancer, types of biopsies, preparation for the procedure, and recovery. We also look at what the results mean, as well as the risks and costs involved.
A doctor typically performs a biopsy on the breast to investigate a lump. A doctor may order a biopsy if a person has signs or symptoms of breast cancer, which can
- a new mass or lump in the breast
- skin dimpling on the breast
- discharge from the nipple
- swelling in an area of the breast
- pain in the breast or nipple
- nipple retraction, in which the nipple turns inward
- thick, red, dry, or flaking skin on the nipple or breast
- swelling of the lymph nodes underneath the arm or near the collarbone
A doctor may also order a biopsy if the results of a mammogram or other imaging tests suggest that a person may have breast cancer.
Most biopsy results do not indicate cancer — only about 20% of breast biopsies lead to a cancer diagnosis. Therefore, if a person needs a breast biopsy, it does not always mean they have cancer. However, a biopsy is the only way a doctor can find out whether a lump is cancerous.
There are different kinds of breast biopsies. For some, a doctor will use a hollow needle. For others, a doctor will make an incision in the skin.
The type of biopsy a person receives can depend on various factors,
- the size of a lump or other change in the breast
- the degree of suspicion a doctor has about how the breast feels or looks
- the location of the lump or other change in the breast
- whether there is more than one area of concern in the breast
- the person’s overall health
- the person’s preferences
- fine needle aspiration
- core needle biopsy
- surgical biopsy
- lymph node biopsy
Below is an explanation of each type.
In a fine needle aspiration, a doctor uses a thin, hollow needle to remove fluid or tissue from a suspicious area of the breast. A pathologist will check the sample under a microscope to determine whether the cells are cancerous.
A doctor may perform a fine needle aspiration for other reasons, such as to relieve pressure from a cyst — a noncancerous fluid-filled sac — or to determine whether a lump is a cyst or a solid mass.
A doctor can perform this procedure in their office. It is typically not painful, as the needle is very thin, but a doctor may administer a local anesthetic.
A person must lie on their back and remain still for the procedure. If the doctor can feel the area that needs a biopsy, they may insert the needle as they feel the area. If the doctor cannot feel the lump, they may use an ultrasound to produce an image of the inside of the breast, which they can use to guide the needle to the lump.
The doctor will remove a small amount of fluid or tissue from the lump. They may repeat this procedure a few times and then cover the area with a sterile dressing.
The procedure typically lasts
If a breast exam or imaging tests suggest that a person may have breast cancer, a doctor may refer the person for a core needle biopsy. This procedure involves using a hollow needle to remove pieces of breast tissue from the affected area.
Doctors can remove more tissue during this procedure than during a fine needle aspiration. This can be beneficial if they suspect cancer.
A doctor may perform the procedure while feeling the lump, or they may use imaging tests to guide them, such as an ultrasound, a mammogram, or an MRI. The procedure usually takes place in the doctor’s office.
A person may sit up, lie on their side, or lie facedown on a special table for the procedure, depending on the imaging the doctor uses.
The doctor will
The doctor may implant a very small marker in the biopsy area so that they can easily locate the exact area in mammograms at a later date.
In a surgical biopsy, doctors remove all or part of a suspicious area so that a pathologist can check the tissue for cancer cells. A surgical biopsy may be:
- incisional, in which the doctor removes part of the area
- excisional, in which the doctor removes the entire tumor or abnormal area
A doctor typically administers sedation and local anesthesia or general anesthesia and then cuts into the breast to remove the suspicious area. The doctor usually needs to stitch the area afterward. They then cover the area with a sterile dressing.
A doctor may perform a lymph node biopsy to determine whether cancer has spread outside the breast. This involves removing one or more lymph nodes from under the arm to check for cancer cells.
If cancer cells are present in the lymph nodes, there is a
Doctors can perform a sentinel lymph node biopsy, in which they remove a few lymph nodes, or an axillary lymph node dissection, in which they remove more lymph nodes. A surgeon may cut the skin over the area of the lymph nodes and remove the affected nodes, or they may remove the lymph nodes during breast cancer surgery, such as a mastectomy.
Risks and complications of a biopsy are typically minimal. They may
- a scar or change in breast shape after a surgical biopsy
- swelling of the breast
- bruising or bleeding, which usually subsides soon after the biopsy
- temporary pain at the biopsy site
In preparation for a biopsy, a person should tell the doctor about any medications they are currently taking, including over-the-counter drugs such as aspirin, which may have a blood-thinning effect. The person should also tell the doctor whether they have any electronic devices implanted in their body before an imaging test and whether they might be pregnant.
A doctor may advise a person not to eat or drink for a certain amount of time before a surgical biopsy if they plan to give the person a general anesthetic.
It may take a few days for a pathologist to analyze the biopsy.
Someone who has had a biopsy may need to change the sterile wound dressing. They should contact their doctor if they experience symptoms of infection, such as a fever, discharge, or redness at the needle site.
A doctor will explain what the results of a breast biopsy mean. If the biopsy results are benign, the pathologists did not find cancerous cells.
If the results show that the sample is cancerous, the doctor will be able to determine the type of breast cancer in the sample, as well as other information.
Types of breast cancer that a pathologist may be able to detect from a biopsy sample include:
- Lobular carcinoma: This cancer affects the milk-producing glands in the breast, called lobules.
- Ductal carcinoma: This cancer affects the breast ducts.
- Paget’s disease: This rare form of breast cancer affects the nipple and areola.
- Inflammatory breast cancer: This rare type of cancer causes the skin of the breast to appear infected.
Depending on the biopsy results, doctors will formulate a cancer treatment plan, which may
- a lumpectomy, in which surgeons remove the tumor from the breast
- a mastectomy, in which surgeons remove the breast
- radiation therapy
- hormone therapy
Costs of breast biopsies vary depending on the type of biopsy a person has and the type of facility. According to Medicare’s website, the total cost of a core needle biopsy in which a doctor does not use imaging is $679–1,507. A person with Medicare would pay $135 or $301 depending on the facility.
Before the procedure, a person should contact their insurance provider to find out how much of the cost their plan will cover.
If a person needs financial help, these services may offer assistance:
CDC National Breast and Cervical Cancer Early Detection Program: This program offers breast and cervical cancer screenings and diagnostic services to people in the United States who have no insurance, inadequate insurance, or a low income.
- Time to Screen: This organization offers information on how to access screening and assistance with affordable care solutions.
How painful is a breast biopsy?
Breast biopsies are usually minimally painful, but a doctor can provide a local anesthetic if necessary.
What percentage of breast biopsies show cancer?
According to the Agency for Healthcare Research and Quality, about 20% of breast biopsies show cancer.
If a doctor suspects that a lump or another breast change may indicate cancer, they may perform a biopsy. This procedure involves the use of a thin, hollow needle to remove a sample of breast tissue or the surgical removal of breast tissue or nearby lymph nodes to test for cancerous cells.
The procedure is typically minimally painful and quick, often taking place in a doctor’s office. A person may have to wait a few days to receive their biopsy results. If the results show cancer cells, doctors will put together a treatment plan based on the type and stage of cancer.
A breast biopsy carries minimal risk and is the only way to find out for sure whether a lump is cancerous or benign. Most breast biopsies show no cancer, but a person should contact a doctor regarding any changes or lumps in their breasts.