When Do You Need a Breast Biopsy?

Changes in breast tissue may lead to a doctor recommending a breast biopsy. Signs that may indicate breast tissue changes can include:

  • Masses
  • Lumps
  • Calcifications
  • Abnormal tissue

When a screening or test discovers an indeterminate or suspicious finding, the radiologist may recommend a breast needle biopsy to see if the mass is benign (noncancerous) or malignant (cancer). A lesion seen by ultrasound can be biopsied using ultrasound as a guide, even if it cannot be felt on clinical or self-breast examination. The physicians at The Women’s Imaging Center use their extensive clinical experience to determine the need for a breast biopsy.

Some breast lesions are not homogenous, have calcification, or are complex in nature. For these, we may recommend a vacuum-assisted breast biopsy. The preparation is almost identical, but the needle (called a probe) is larger and is a single insertion. Using ultrasound guidance, we insert the probe at the target site and use a gentle vacuum to extract the lesion. We usually place a biopsy clip at the site of removal. This procedure is also referred to as a minimally invasive non-surgical excisional biopsy. Afterward, the biopsy sample is prepared and delivered to the Pathologist for processing and interpretation.

Ultrasound Features of Breast Masses

The radiologist looks for particular criteria of the mass, such as shape, orientation, the margin of the mass, lesion boundary, echo pattern, and posterior acoustic features. This lexicon was established by the American College of Radiology and is called the Breast Imaging-Reporting and Data System (BIRADS). For example, a well-circumscribed isoechoic oval nodule oriented parallel to the skin with a distinct lesion boundary is most likely to be a benign fibroadenoma. These mass characteristics would be categorized as BI-RADS 3: Probably Benign. On the other hand, an irregular spiculated hypoechoic mass taller than wide with posterior shadowing with surrounding echogenic halo is more likely to be malignant (cancer). This lesion would be categorized as BI-RADS 5 with the recommendation for breast biopsy.

This is where experience matters. The Women’s Imaging Center specialized and fellowship radiologists have decades of experience to help provide a more certain diagnosis. 

What to Expect With a Breast Ultrasound Biopsy

At The Women’s Imaging Center, we perform procedures on-site for your comfort and convenience. We offer ultrasound-guided breast biopsy at any one of our multiple locations. If you need a vacuum-guided breast biopsy, that procedure is performed at our main Denver/Cherry Creek location.
Preparing for the Biopsy
We ask that you do not take medicines that can thin the blood unless you are directed to continue taking them by your referring physician. Some patients may have special reasons to stay on their blood thinners, such as a recent metal-bore cardiac stent or clotting disorder. Always listen to your referring clinician regarding those decisions. We advise against taking aspirin if you are solely on it for prevention reasons. Please refrain from any rigorous activities for one to two days after the procedure. So plan your exercise regimen either before or several days after your ultrasound-guided breast biopsy. Even though there will be only a tiny nick on the skin, we want to minimize the chance of soreness, infection, or bleeding at the site. 
During the Biopsy
You will see several assistants, including a medical assistant and/or ultrasound technologist, to help the radiologist perform the procedure. The medical assistant or technologist will ultrasound the area to localize the finding for the breast needle biopsy. The radiologist will anesthetize the skin with a tiny numbing needle and use the ultrasound transducer to watch the entire procedure for better positioning. Using ultrasound allows the radiologist to visualize and accurately sample the lesion in 3D and avoid adjacent anatomy. Another special needle called a core needle is inserted at the target site. This needle has a hollow center and is spring-loaded into a hand-held device. When a sample is taken, you will hear a clicking sound similar to the sound you remember when getting your ears pierced. However, you shouldn’t feel any discomfort due to the local anesthetic.
After the Biopsy

You will likely experience slight bruising of the breast for a few days. Some women may complain of feeling a lump under the biopsy site for up to a week. This lump is from the serum and blood that the body sends to the biopsy site, which is its natural way of healing that area. If the lump is the size of a small plum or larger, please reach out to our clinical care team at 303-321-2273. Select the “physician/patient pathology” phone extension, option x 228, x 235, to discuss any changes to your protocol.

Infection is extremely rare, but call us if you have a fever, chills, or any redness at the site of the biopsy. Some people may experience contact sensitivity from the tape on the skin, which appears red, but this is often associated with a geographic non-warm, non-streaking area that perfectly fits the line of the tape. If you are sensitive to the tape, remove it and wear a tight sports bra instead. Call your referring clinician or us if you have any concerns.

Results are available in 1-2 working days after the ultrasound-guided breast needle biopsy. The Women’s Imaging Center Patient Navigator and the Radiologist correlate the results and coordinate any follow-up care or management indicated. A follow-up ultrasound within six months after the biopsy may be recommended even for benign biopsies. A contrast breast MRI can help with treatment planning if the biopsy proves to be cancer. We will work with your referring clinician to coordinate an individualized treatment plan with surgeons or oncologists to fit your particular needs.

Breast Ultrasound-Guided Biopsy in Denver

Meet Our Specialists

Founded over 27 years ago, The Women's Imaging Center is Colorado's only comprehensive women's imaging center. Unlike most other imaging centers, we provide imaging of the whole woman rather than just individual organs. This interrelated examination allows our specialists to improve their interpretation of images and facilitate a quicker, more accurate diagnosis. Our goal is to provide our patients with the clearest results and the most exceptional experience at all our Colorado based Centers.

Kelly McAleese, M.D.

Timothy Colt, M.D.

Barbara Jaeger, M.D.

John Lewin, M.D.


Frequently Asked Questions About Breast Ultrasound Biopsy

When is a breast biopsy needed?

We may recommend a breast biopsy if an abnormality is detected during a mammogram, ultrasound, or clinical breast exam. A biopsy is used to determine if the abnormality is cancerous or benign.

How is a breast ultrasound biopsy done?

During a breast ultrasound biopsy, a small tissue sample is removed from the breast using a needle guided by ultrasound during a breast ultrasound biopsy. The procedure typically takes about 30 to 60 minutes and is performed under local anesthesia.

We begin by cleaning and numbing the area with a local anesthetic. A small incision is made, and a biopsy needle is inserted into the breast tissue. The ultrasound helps determine the precise location of the abnormality. A small tissue sample is removed and sent to a laboratory for examination.

Why would I need a breast ultrasound after my mammogram?

A breast ultrasound may be recommended after a mammogram if there are any suspicious findings on the mammogram that need further evaluation. A breast ultrasound can provide more detailed images of the breast tissue and help identify abnormalities that may require additional testing or treatment.

How long does it take to get the results?

Results from a breast biopsy are usually available within a few days to a week. However, in some cases, it may take longer for the results to be processed and reviewed.

We Provide Breast Ultrasound Biopsy in Denver

We serve patients in the Greater Denver area, with multiple locations for your convenience. Discover how fellowship-trained radiologists with state-of-the-art technology can elevate your care when receiving an ultrasound biopsy of the breast.