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:
- 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
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
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Frequently Asked Questions About Breast Ultrasound Biopsy
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.
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.
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.
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.