What To Expect When You Need a Breast Biopsy

Breast imaging naturally brings anxiety for many women, even with preparation. But hearing you need a follow-up biopsy can quickly trigger a whole new wave of worry and uncertainty.

Questions may arise, such as: What is a biopsy, and why do I need it? Is it painful? Does it mean I have breast cancer? This uncertainty is normal, so here we will provide you with useful information to help you understand more about this often routine, diagnostic test.

More than one million women in the United States have breast biopsies annually. While this number may seem high, it indicates that doctors take early detection seriously — they would rather look closely at uncertain tissue than risk missing early-stage cancer.

“A recommendation for a biopsy does not automatically mean a diagnosis of cancer. Imaging is so advanced that is may show findings that have suspicious features, but ultimately are benign on a biopsy.”

Jana Deitch, MD, Chief for Breast Surgery at Catholic Health and Director of the Breast Health Program at St. Catherine of Siena Hospital

What is a core needle biopsy?

If a mammogram or ultrasound shows you may have a suspicious finding, a radiologist will often recommend a core needle biopsy (core biopsy) as a more advanced diagnostic test.

A core needle biopsy uses a hollow needle to remove a sample of tissue from the breast. It is the standard for diagnosing or ruling out breast cancer without surgery.

A core needle biopsy uses a thicker needle and removes more breast tissue than a fine needle aspiration (FNA). An FNA uses a thin, hollow needle and syringe to remove tissue for biopsy samples. Your radiologist may use an FNA if the suspicious area is a fluid-filled sac (cyst).

What does a core needle biopsy examine?

A core needle biopsy can examine a breast lump or suspicious area. The needle removes samples of breast tissue from the area in question. A core needle biopsy can help determine the type of tumor and whether the tumor will respond to hormone treatment.

How to prepare for a core needle biopsy

Before the procedure, you will be given specific instructions to follow. If you have any concerns, ask questions so that you feel comfortable when you arrive.

Some general guidelines that can help you prepare for your procedure include:

Eating a snack or light meal beforehand
Skipping deodorant or lotion to avoid ingredients getting visualized on imaging tests
Wearing a sports bra for extra support after the biopsy

Let your radiologist know if you are pregnant or may be pregnant. If the core needle biopsy does not provide a clear answer, you may need a surgical biopsy, a type of biopsy that requires general anesthesia, which can carry a small risk to a fetus.

Also, let them know if you are taking blood-thinning medication. They may adjust your medication before the biopsy to prevent excessive bleeding.

What to expect during a core needle biopsy

Knowing what to expect before your biopsy can help calm your nerves and ensure the procedure goes smoothly. The appointment will take about two hours, although the biopsy itself will go quickly.

A local anesthetic is injected to numb the area around the biopsy site to keep you comfortable.

Once the needle is inserted, a small amount of tissue is removed. You may feel a slight pressure while the samples are taken. Your radiologist will use breast imaging to help guide the needle to the suspicious area via mammography, ultrasound, or MRI guidance. Sometimes, they may use a vacuum-assisted biopsy device to remove a tissue sample.

After removing the tissue samples, a small metal marker (clip) is inserted to mark the biopsy site. If the biopsy shows cancerous cells, a radiologist can easily find the site to remove more tissue. You will not feel the clip, and it will not affect future imaging. Medical tape is placed over the biopsy site.

Follow-up care after a core needle biopsy

After the procedure, pressure is put on the biopsy site to prevent blood clots. You may feel soreness at the biopsy area for a few days after the procedure. To help with the discomfort, you can take over-the-counter pain relievers. You may also experience normal bruising around the biopsy site. Avoid vigorous activity, and do not lift anything heavier than five pounds.

Your care team will give you further instructions on what to do after the biopsy and when to schedule necessary follow-up care. Follow their guidance closely.

You will likely need to keep your medical tape on for seven to 10 days after the procedure. Wear a sports bra for extra support and prevent hematomas (clotted blood pools).

Call your physician immediately if you have any signs of infection, such as redness or pus, as it may mean you need medical treatment.

Keep the biopsy site clean and dry for 24 hours to prevent infection. You can take a shallow bath the day of your biopsy and shower 24 hours after the biopsy. You can also remove your bandage 24 hours after the biopsy. The medical tape will usually fall off on its own after three days; if not, you can remove it yourself.

Patients can usually return to work and resume regular activities immediately after the procedure. However, some patients may choose to rest the day of the procedure.

Next steps after a core needle biopsy

The results of the biopsy are usually available within a week after the procedure. Your care team will review the results with you and explain any next steps.

Depending on the results, your physician may recommend more frequent monitoring with mammograms and other imaging tests. If cancerous cells are detected, you will be referred to specialists, including a breast surgeon, medical oncologist, and radiation oncologist, to discuss your specific type of cancer and treatment options.

Learn more about the advanced breast cancer services available at Catholic Health.