What To Expect If You Need A Breast Biopsy

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Millions of people get breast biopsies every year, and yet the ins and outs of the procedure are seldom openly discussed.

Breast biopsies help doctors diagnose different types of breast lumps and lesions. If your radiologist can’t immediately rule out cancer based on the imaging tests, they’ll most likely recommend a breast biopsy to get a sample of the tissue and take a closer look under a microscope.

Past research has shown that most people find the breast biopsy experience at least a little distressing. It’s understandable — after all, you’re waiting on results that could drastically alter the course of your life. But a recent report found that nearly 82% of people who were worried about getting a breast biopsy said after the fact that the procedure was better than they expected.

By reading up and preparing for the procedure — and, perhaps, practicing some mindfulness along the way — your breast biopsy journey can become a little less frightening. After all, breast biopsies are safe, reliable procedures that can give you some much-needed answers and kick-start your treatment plan if need be.

Here’s what to know and what to expect when you need to get a breast biopsy:

If somebody has a symptom involving their breasts — whether it’s a lump or persistent pain — they’ll likely undergo imaging (think: an ultrasound or mammogram) so their doctor can get a closer look at what might be causing the issue.

If the imaging tests come back abnormal, your physician may recommend that you get a breast biopsy to obtain a clearer diagnosis. During a breast biopsy, a small needle is inserted into the breast to collect a sample of tissue. That tissue is then evaluated under a microscope to determine whether an abnormal growth or lesion detected on imaging tests is cancer. You’re not sedated during a breast biopsy, but a local anesthetic, lidocaine, is used to numb the area where the needle is inserted.

According to Dr. Andrea Abbott, an assistant professor at Temple Health’s Fox Chase Cancer Center in Philadelphia, lidocaine is the same type of numbing medicine that your dentist would use. “It can burn when it is being injected, but this sensation should go away quickly,” Abbott said.

There are three types of breast biopsies, and the type you get largely depends on the imaging device where the lesion showed up.

The first type is a stereotactic biopsy, which doctors conduct while using a mammogram to see where the growth is. The breast is numbed and put in compression, which can be pretty uncomfortable.

Dr. Janie Grumley is a breast surgical oncologist and director of the Margie Petersen Breast Center at Providence Saint John’s Center in Santa Monica, California. She explained that a stereotactic biopsy is basically like getting a mammogram that lasts for 20 to 30 minutes. Occasionally, the biopsy needle can hit a blood vessel in the breast and cause some minor bleeding.

There are also ultrasound-guided biopsies, which are more commonly performed in women with dense breasts. The patient lies on their back while an ultrasound probe is used to detect where the lesion is. The skin is numbed, then the needle is inserted to collect the sample. Because the needle used in this type of biopsy is smaller, it’s less common for it to hit a blood vessel — but it can happen, according to Grumley.

The third type is an MRI-guided biopsy. This is recommended for patients who have a lesion that is only visible on an MRI. “It’s a bit more involved, the breast does have to be held still during the biopsy, and [the patient] is coming in and out of the MRI machine,” Grumley said.

Though the numbing medicine helps prevent sharp, shooting pains, some patients still feel pressure and vibrations. “I always tell patients that everyone reacts to the numbing medicine differently, so it’s important to communicate with your doctor during the biopsy if you feel anything,” Abbott said.

It usually takes 24 to 48 hours to get your breast biopsy results, but at some centers it could take up to five days or so. Grumley said results aren’t given immediately because breast tissue, which is fatty, needs to be fixed — a chemical process that prepares the tissue for inspection.

The results come in three categories: benign (which involves normal changes in the breast), cancer, and risk lesion (something that looks abnormal but doesn’t seem to be cancer). If cancer is detected, the breast biopsy will give insights as to the type of cancer it is and the treatment methods it will best respond to.

“It could really help guide somebody when it comes to treating a breast cancer,” Grumley said. Biopsy results cannot tell you what stage the cancer is, according to Abbott. If risk lesions are detected, you will likely be referred to a surgeon who can do a small surgical procedure to collect more tissue and confirm whether there is cancer in the breast.

In certain cases, patients may need to get another biopsy. Occasionally, the mammogram results and biopsy results don’t fully add up, and more tests are needed to figure out what’s going on. The radiologist (who handles the imaging results) and the pathologist (who evaluates the biopsy) always review and compare their findings.

“The two have to have that discussion to make sure that what they’re seeing under a microscope makes sense to what they’re seeing on imaging,” Grumley said.

Most breast biopsies come back as benign, or as a risk lesion that ends up being benign. In fact, only about 10% of breast biopsies turn out to be cancers, according to Grumley.

It’s natural to feel some anxiety about getting a breast biopsy. Anxiety feeds off of the unknown, and there’s no shortage of unknowns when you’re searching for a medical diagnosis. “This is a completely normal response to an unknown procedure and to the possibility of the biopsy resulting in a cancer diagnosis,” Abbott said.

Research has found that mindfulness, or the practice of being in the present moment, can help patients relax before getting a breast biopsy. If permitted, music can also help calm your nerves during the procedure.

Grumley recommends talking to your radiologist, since they can, in a way, prepare you for any answer based on clues from your imaging tests. Jot down any questions you have and ask your doctor about the procedure so you have a clearer idea of what to expect going into it.

“Once you learn about that process, it’s less scary,” Grumley said.