Several different techniques of breast biopsies are available and the following information is used as a guide for what to expect
Stereotactic (Mammogram-Guided) Breast Biopsy
This type of biopsy can be used for breast masses or calcifications that are seen on mammogram. This procedure is scheduled in the Women’s Health Center at Mt Carmel East or Mt Carmel West. Typically, the procedure takes approximately 30 minutes to perform, and the appointment time is just over an hour. During this procedure, a woman lies on a table on her abdomen, and her breast dangles through a hole in the table. The breast is compressed while mammograms are then taken to target onto the desired site to biopsy. A local anesthetic is used on the skin, and a small 2mm incision is made on the breast to take samples. After the procedure, a small clip is placed at the biopsy site for post-procedural marking. A paper tape closes up the incision site.
Most women have little pain at the site and breast. Bruising is not uncommon after the procedure and we ask that you wear a tight bra for support for the next few days and not perform rigorous activity. Excessive bleeding would be rare, but possible. A small ice pack will help with discomfort and bruising. Acetaminophen (Tylenol) or Ibuprofen (Motrin) will be sufficient for pain control, if needed. Women may shower the next day, but we ask that you do not swim or submerge your breast in a bath for about a week.
US (Interventional Radiologist) Breast Biopsy
Sometimes we determine that a mass or cyst needs biopsied by the interventional breast radiologist, and we will arrange this in the Women’s Health Center at Mt Carmel East or Mt Carmel West. During this procedure, you will lie on your back, and an ultrasound will be used to localize the mass or cyst. You will then have a local anesthetic placed into the skin, and a small 2 mm incision is then made. A needle is inserted into the breast to take samples, and a small clip is placed at the biopsy site for post-procedural marking. A paper tape closes the incision site. The same post-procedural instructions are recommended as for the stereotactic mammogram biopsy.
MRI Guided Breast Biopsy
Sometimes a breast abnormality is only visualized on MRI imaging. This is an unusual circumstance, as most women do not need breast MRIs for screening or evaluation. However, if this is the case for you, the biopsy technique is similar to the above described procedures, and involves a biopsy with the MRI machine on your abdomen. Most women tolerate this well, just as above, and the post-procedural instructions are the same.
Excisional Breast Biopsy (Lumpectomy)
This is a biopsy that is done in the operating room, and is a procedure to remove the entire breast lump. Some women opt to have this performed, in lieu of, or after, the above procedures have been performed. Typically, excisional biopsies are outpatient procedures, performed either in the main hospital at Mt Carmel East or Mt Carmel West, or may be done at the outpatient surgical centers, Green Street or Taylor Station. This procedure takes approximately 1 hour in the operative suite. A patient may have a general anesthetic or a sedation anesthetic, depending on location of the mass and patient or physician preference.
After surgery, you will typically have paper tapes on your incision, which should not be removed for at least a week. You may shower 24-48 hours after the procedure, but please no swimming or submerging your incision in bath water for at least a week. You may have some minimal pain, which may require a few days of narcotic pain medicine, but most women take only Tylenol or Ibuprofen for their discomfort. A tight supportive bra is encouraged. Additional risks of excisional breast biopsy include the risks of anesthesia, risk of wound infection, bruising or bleeding at the surgery site, and possible need for repeat surgery, depending on your final pathology. Some women may notice a slight breast volume loss at the surgery site, but many others notice no difference once fully recovered from surgery. Some women also may develop a fluid collection at the surgical site; this will typically be reabsorbed by your body, over time. Infrequently, this fluid collection may leak slightly from your breast or need aspirated out with a needle in the office. These other topics will be discussed with you by your surgeon at your consultation.
After each of the above-described procedures, your pathology will be available in a few days. After these results are available, we will ensure that the pathology is an accurate representation of your abnormal imaging. Your follow up plans will be determined by your pathology results. Please call the office 72-96 business hours after the procedure to follow up on your pathology. If you would like a copy of your pathology results for your medical records, and we have forgotten to offer one to you, please ask, and they will be available for your pick up after the physician has signed off on them.
