Does a Breast Biopsy Hurt?

What Is a Breast Biopsy?

A biopsy is the final stage of diagnosis for all types of cancer, including breast cancer. This procedure involves removing a small amount of fluid or tissue, called a sample, from the area that is suspected to be cancerous. The sample is tested in a medical laboratory to look for cancer cells and, if there are any present, to learn more about the cancer’s unique characteristics. A biopsy can tell oncologists:

• Whether the tissue is cancerous
• The breast cancer type and grade
• Whether cancer cells have spread outside the breast gland
• Whether cancer cells use hormones to grow
• The molecular properties of the cancer cells

Biopsy results are used to confirm a cancer diagnosis and to plan an appropriate treatment. Certain hormonal and molecular properties may indicate that the cancer is likely to respond to certain treatments, such as hormone therapy or targeted therapy.

How Is a Breast Biopsy Done?

A breast biopsy can be performed using a few different approaches. The specific type of biopsy used depends on a variety of factors, including:

• How large the suspicious area is
• Where it is located in the breast
• If there is more than one suspicious area
• How healthy the patient is
• What test type the patient prefers

The oncologist weighs all of these factors carefully before choosing the best biopsy method. The types of breast biopsy that may be used include:

• Fine needle aspiration: This type uses a very thin needle to take a sample. It is most often used if the suspicious area is likely to be a cyst, or a non-cancerous sac of fluid.
• Core needle biopsy: This type uses a slightly larger hollow needle to take a more substantial sample. It is the preferred option for diagnosing breast cancer.
• Surgical biopsy: This type removes most or all of the suspicious tissue for testing, and sometimes some of the surrounding tissue as well.

Needle biopsies are the most common type used. Surgical biopsies are typically used only if the results from an earlier core needle biopsy were inconclusive or if the suspicious area is difficult to reach with the biopsy needle.

Preparing For a Breast Biopsy

Before a breast biopsy, the physician will provide instructions on how to prepare. Breast biopsies do not require extensive preparation, though some types need more than others:

Needle Biopsies

Patients can usually eat, drink, and take medications as normal before a core needle biopsy. If the patient is taking blood-thinning medications, however, they may need to pause them before the test. This helps to prevent excessive bleeding during and after the biopsy.

Surgical Biopsies

Surgical biopsies are sometimes performed under general anesthesia. If this is the case, then patients may need to stop eating and drinking for a few hours before the test. Blood-thinning medications should also be paused before the test to prevent excessive bleeding.

How Painful Is a Breast Biopsy?

Breast biopsies are not painful. The procedures typically are done in an outpatient setting, such as in the doctor’s office or an outpatient surgical center. The procedure is typically very quick, though it may take longer if imaging guidance or surgery is needed. The process for each type is as follows:

Needle Biopsies

1. The individual is asked to sit up, lie flat on their side, or lie face down over special openings.
2. The radiologist uses a thin needle to administer local anesthesia to numb the area that will be biopsied.
3. The radiologist makes a small incision in the breast, usually a quarter inch or less.
4. The radiologist uses imaging technology, such as mammography, ultrasound, or MRI, to guide a needle toward the suspicious area. The patient may feel a slight pressure.
5. The radiologist places a tiny tissue marker, also called a clip, into the biopsy area. This marker cannot be felt but will show up on imaging to guide follow-up testing or treatment.
6. Once the biopsy is complete, the radiologist removes the needle.
7. The radiologist applies light pressure to limit bleeding before the area is covered with a sterile dressing.

Needle biopsies do not hurt. The local anesthesia keeps the breast numb during the procedure, so the patient should not feel more than light pressure. An IV (intravenous) sedative may be provided to help the patient relax during the procedure.

Surgical Biopsies

1. The patient is asked to lie down on an operating table.
2. The surgeon administers local anesthesia to numb the breast or uses general anesthesia to put the patient to sleep during the procedure.
3. The surgeon makes a small incision in the breast over the suspicious area.
4. The surgeon uses imaging technology to guide their tools as they remove part or all of the suspicious growth. Nearby tissue may also be removed.
5. The surgeon closes the incision with stitches and covers it with a sterile dressing.

As with core needle biopsies, surgical biopsies are not painful. The use of local or general anesthesia means that the patient stays comfortable through the procedure.

After a Breast Biopsy

People can usually return to normal everyday activities after a breast biopsy, though they may need to limit strenuous activity for a day or two. The doctor or nurse will provide instructions to care for the biopsy site, change dressings, and watch for signs of infection.

Breast biopsies can cause light bleeding, bruising, or swelling. This can make the breast seem larger. In most cases, this is nothing to worry about and will go away as the breast heals. The doctor will tell the individual when to call about issues. Needle biopsies do not leave any permanent mark, though surgical biopsies may create a small scar. Surgical biopsies may also change the shape of the breast, depending on how much tissue was removed.

Receiving a Breast Cancer Diagnosis

Breast biopsy lab results can take a few days to a few weeks to prepare. When they are ready, the physician will contact the patient to schedule a follow-up appointment. This appointment is an opportunity to discuss lab results, including whether cancer was present and, if so, what the rest of the biopsy report means.

Not all breast biopsies identify cancer. In many cases, the suspicious area turns out to be harmless or the result of a benign condition, such as mastitis (a breast infection) or a cyst. If so, the patient may begin treatment for that condition. If cancer is detected, however, then patients must speak with an oncologist about what the next steps are. Further testing may be needed before treatment can begin.

Find Comprehensive Breast Cancer Care Near You in NJ, CT, & MA

Breast biopsies are an important part of cancer diagnosis, and they aren’t as frightening as they sound. Understanding what to expect from medical procedures can help patients feel more confident about their treatment. Regional Cancer Care Associates educates patients to help them avoid life-threatening cancer. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.