What is a breast biopsy?

This is when the doctor removes a small piece of tissue or a sample of cells from the abnormal area. A doctor who specialises in studying cells (pathologist) looks at the sample under a microscope to check for cancer cells.

For a few days after the biopsy, your breast may feel sore and bruised. Taking painkillers and wearing a supportive bra will help with this. Any bruising will go away in a couple of weeks.

There are different ways of taking a biopsy. Your doctor or nurse will explain the type of biopsy you will have. Because DCIS cannot usually be felt, you will often need a mammogram or ultrasound to guide the biopsy needle to the abnormal area.

Needle biopsy with mammogram

This is also known as a stereotactic needle biopsy.

You will be positioned in a mammography machine that has a special device attached. In most units, the test is done while you are sitting down. In a few units, women are asked to lie on their front. The radiographer then takes an x-ray of the breast from two different angles to work out the exact position of the abnormal area. They then insert a needle into the right place to take a sample. Before taking the biopsy, the doctor will inject some local anaesthetic into the area to numb it.

Ultrasound-guided needle biopsy

Sometimes an ultrasound scan is used to show where the abnormal area is. This helps the doctor guide a needle through the skin into the exact area to take a biopsy. You will have a few biopsies taken from the area. You may feel some pressure, but this should only last for a short time.

Vacuum-assisted biopsy (VAB)

This is a way of taking needle biopsies using a vacuum-assisted method. The doctor gives you an injection of local anaesthetic into the skin to numb the area. They then make a small cut and put a needle through it into the breast. A mammogram or ultrasound picture helps them guide the needle to the right area. The doctor places the needle, which is attached to a suction device, into the area. Using gentle suction, they remove the breast tissue into a small container. They can take several biopsies without needing to remove the needle and put it in again.

Clip insertion

When a needle biopsy is done, sometimes a tiny metal marker or clip is placed where the biopsy was taken. The clip shows up in mammograms and marks the area where the biopsy was taken. This helps the surgeon find the exact area again if you need to have more breast tissue removed later on. The clip is very small and will not cause you any harm or discomfort, even if it is not removed. If DCIS is diagnosed, the clip is usually removed during surgery.

Excision biopsy

Sometimes it is not possible to remove enough tissue to make a diagnosis with a needle biopsy or a VAB. In this case, you may need a small operation. You will be referred to a specialist breast surgeon to have an excision biopsy under a general anaesthetic.

The surgeon makes a cut in the skin of the breast and takes a biopsy of the breast tissue. You usually go home on the day of your operation. But some people may need to stay in hospital overnight. Usually, you have stitches that dissolve and do not need to be removed.

Wire localisation

Sometimes, an x-ray or ultrasound is used to guide a fine wire into the breast. The wire marks exactly where the surgeon should take the biopsy. The surgeon removes the wire when the excision biopsy is done.

Sometimes a tiny amount of a harmless radioactive substance is injected into the area of micro-calcification. The surgeon then uses a special hand-held probe during surgery to guide them to the area that needs to be biopsied.

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