Key takeaways:
If you’ve been advised you should have a breast biopsy, your first question may be “What percentage of breast biopsies are cancer?”
The good news is that most breast biopsies are not cancer. In fact, 80% come back as noncancerous. Advances in screening technology have increased the ability to detect abnormalities in breast tissue. And since they can catch cancer in its early stages, breast biopsies are often recommended when something unusual is seen.
Your medical team may recommend a few types of biopsies, and there are a few ways you can prepare for your biopsy and be proactive while you wait for results.
A patient will need a breast biopsy if an abnormal result is seen on a screening exam or if a breast lump is identified. Screening mammograms, breast ultrasounds, and breast MRIs are all types of screening tools used to evaluate for breast abnormalities.
Mammography technology such as 3D mammograms and breast MRIs can see more breast tissue than ever before.
This means they see abnormalities that may be suspicious for cancer, but it’s impossible to know for sure without testing a piece of the abnormal tissue. This is where breast biopsies are valuable—they allow your healthcare team to take a small sample of that breast tissue and examine it under a microscope.
Breast biopsies are typically recommended after a clinical breast exam, mammogram, or breast MRI.
If someone feels a lump or has breast changes, they most likely will have one or more imaging tests first (as they are fairly noninvasive) before heading into the hospital for a biopsy.
The type of breast biopsy your healthcare practitioner will recommend depends on a few factors. According to the American Cancer Society, some of these factors include:
If the suspicious area is small, a fine needle aspiration (FNA) biopsy may be recommended.
This involves using a very thin, hollow needle that is attached to a syringe to take a small sample of the tissue in question. The syringe withdraws, or aspirates, some of the tissue and fluid so a pathologist can examine it under a microscope.
Since only a small amount of tissue can be evaluated with an FNA biopsy, core needle biopsies have become more common.
A core needle biopsy also uses a needle and a syringe (like the FNA biopsy), but it is slightly larger to allow for more breast tissue to be examined. Several samples or “cores” of tissue are often removed so that different areas around the abnormal tissue can be evaluated.
Surgical biopsies involve removing part of the entire area of concern so it can be thoroughly evaluated for breast cancer.
Surgical biopsies are typically reserved until after an FNA or core needle biopsy has been done and will be used if the results from the initial test weren’t totally clear.
As the name suggests, surgical biopsies are considered a surgical procedure and involve a surgeon making an incision to remove the suspicious areas.
Behind skin cancers, breast cancer is the most common cancer in women. Of all the women in American, 13% will have breast cancer at some point in their life (roughly one in eight women), so it’s only natural to think most breast cancer biopsies are cancerous.
Thankfully, only 20% of breast biopsies come back as cancer. This means four out of five times, there is no cancer found.
This is because advances in breast imaging have increased the ability to closely examine breast tissue.
Better imaging means more variations are being seen, and it’s still difficult to know for certain if a variation is a woman’s natural and normal state or if something like cancer is starting to develop.
Patients typically have an FNA or core needle biopsy done in the surgeon’s office and don’t require a trip to the hospital.
The medical provider will most likely use medicine (local anesthesia) to numb the area around where the needle will be inserted. However, this isn’t always necessary, specifically with FNA biopsies, as the needle is so small.
The patient will lie on their back and have to remain still during the procedure. An ultrasound may be used to help guide the doctor so they can see where to place the needle—this doesn’t hurt but can feel like pressure as they move the handpiece around.
FNA biopsies and core needle biopsies only take a few seconds to obtain, but the entire procedure start to finish typically takes 20-30 minutes to complete.
Since no incisions are needed, patients don’t require stitches, but probably will have a small bandage placed over the biopsy site while it heals.
Surgical biopsies are usually done in an outpatient surgical setting. They are more invasive than FNA or core needle biopsies, but patients typically go home after the procedure. In addition to local anesthesia, patients are given intravenous (IV) medication—often called twilight anesthesia—to help them feel drowsy.
In certain scenarios, patients need general anesthesia, which involves being put into a deep sleep during the procedure.
There are usually a few stitches after surgical biopsies that may have to be removed several days afterward.
Since anesthesia is given during surgical biopsies, people aren’t able to drive home and will require someone to take them home and keep an eye on them for the rest of the day.
After a breast biopsy, the tissue sample is sent to the lab for a pathologist to evaluate under a microscope. They will look for cancer cells, infection, and any other explanation for the cause of the abnormal area.
The results, or pathology report, can take several business days to return. Your healthcare provider will either call you with the biopsy results or have you return for an office visit to review the findings.
From there, a treatment plan can be made, which may include either a referral to an oncology team if it is cancer or a follow-up plan with more frequent screening.
Sometimes no definitive plan is needed, especially if the tissue is a calcification, cyst, or other benign (noncancerous) finding.
Breast cancer may be the most common cancer in women (other than skin cancers), but thankfully more breast cancers are being found early.
3D mammograms and breast MRIs are two of the best ways for your healthcare team to keep a close watch on any breast changes or abnormalities. These screening tools help your medical provider determine whether a closer look with a breast biopsy is needed.
At ezra, we offer a full-body MRI which screens for abnormalities in up to 13 organs, including the breasts. Find an ezra location near you.
