An MRI-guided breast biopsy — also called MRI-guided core needle biopsy — is a minimally invasive outpatient procedure.
During the procedure, a breast radiologist uses MRI imaging to guide a needle into a specific area of breast tissue to take a small sample for testing. It is performed to help your care team accurately diagnose breast cancer and other conditions.
UPMC breast imaging experts provide compassionate diagnostic care using the most advanced technology. Our leading-edge MRI technology, combined with our minimally invasive needle biopsy techniques, allows our breast biopsy teams to deliver the fast and accurate results you need.
An MRI-guided breast biopsy — also called MRI-guided core needle biopsy — is a minimally invasive outpatient procedure. During the procedure, a breast radiologist uses MRI imaging to guide a needle into a specific area of breast tissue to take a small sample for testing. It is performed to help your care team accurately diagnose breast cancer and other conditions.
Your doctor may recommend an MRI-guided breast biopsy if a breast imaging exam shows that you have abnormal breast tissue.
MRI-guided breast biopsies do not use radiation, making them a safe option for accurately evaluating a range of breast conditions. When compared to surgical breast biopsy, MRI-guided breast biopsy offers benefits including:
You may be a candidate for MRI-guided breast biopsy if you have a suspicious area of breast tissue and your doctor recommends taking a sample for testing in a lab.
Like all medical procedures, MRI-guided breast biopsy has some minor risks, including:
Your doctor will explain the procedure to you and answer your questions. To prepare for the procedure, you should:
On the day of your procedure, arrive one hour before your scheduled procedure time. Be sure to bring your photo ID, health insurance card(s), and a written order/prescription for the biopsy from your referring provider.
You should wear a two-piece outfit (shirt and pants/shorts) and bring a sports bra, if you have one. Wearing a supportive bra after your procedure can minimize breast movement and discomfort.
If you receive medication to help you relax during the test, you will need to arrange for someone to drive you home from the imaging center. Otherwise, you should be able to drive home and resume normal activities right away.
MRI-guided breast biopsies take about 45-60 minutes. However, you should plan to be at the breast center for up to two hours.
You will receive local anesthesia medication to numb the biopsy area, which will burn for about 15 seconds. You may feel mild pressure during the biopsy and your breast will be in gentle compression, but it should not be painful.
When you arrive at the imaging center, a nurse will start an IV in your arm so you can receive the intravenous contrast agent (gadolinium). When the gadolinium is injected, it may feel cold for a few seconds. The contrast will travel through your bloodstream and highlight suspicious areas in your breast.
You may also receive medication to help you relax during the test.
You will lie face down with your arms above your head on a special MRI table that has openings for your breasts. The breast to be biopsied will be gently stabilized in a plastic grid. The table then slides into the MRI machine, which looks like a tunnel.
When you are inside the MRI tunnel, the MRI machine moves around you and makes knocking noises while taking a series of images. The images are taken to locate the area of concern in your breast. It is important for you to be still during the procedure. After the images are taken, the table will slide out of the MRI tunnel.
Your doctor will use local anesthesia to numb the biopsy area. Your skin will be cleaned, and you will receive an injection of numbing medication. The medication may cause a burning sensation that lasts about 15 seconds. You may feel pressure during your biopsy procedure, but you should not feel any pain.
After your breast is numb, your radiologist will make a small incision in your skin and insert a needle using MRI guidance. Your care team will take another three-minute MRI scan to confirm that the needle is in the correct position. After the MRI table slides out from inside the scanner, your doctor will use a vacuum-assisted needle biopsy device to take a tissue sample. You may feel some vibration while several tissue samples are taken.
Your radiologist will place a tiny titanium clip at the biopsy site to mark the area for future breast imaging or surgery. The clip does not set off metal detectors and is MRI-compatible.
Your nurse will put gentle pressure on your incision for about 10 minutes after your procedure to reduce bleeding. Would-closure strips and a bandage will be placed over your incision. The wound-closure strips should not be removed until they fall off on their own in about a week. You will also have a mammogram to confirm that the clip was placed in the proper place.
You should be able to drive home after your breast biopsy procedure and resume your normal activities within a few hours. You may notice some discomfort or bruising around the biopsy area, which should improve within 7-10 days.
During your recovery, you should:
Call your doctor right away if you notice signs of infection or complications including:
After your MRI-guided breast biopsy, our team will make sure you receive the follow-up care you need.
Our experts understand that waiting for biopsy results can be stressful. It is important to remember that most breast biopsies turn out to be benign (noncancerous). The nurse will call, or make sure that your healthcare provider has called, to inform you of your biopsy results as soon as your results are received from the pathology department. This usually takes 2-4 business days after your biopsy. When your results are ready, they will be available immediately in your patient portal.
About 20 percent (1 in 5) of all MRI-guided breast biopsies show cancer.
If your biopsy indicates cancer, you will be referred to a team of UPMC breast cancer experts for treatment. UPMC is nationally recognized for breast cancer care and offers the most advanced treatment options, including surgery, radiation, chemotherapy, and hormonal therapies, as well as a range of complementary therapies. Physicians specially trained in the management of breast cancer will review your case with you and develop a personalized treatment plan. Our supportive care team can help you and your loved ones manage the many emotions and questions that may arise throughout the diagnosis, treatment, and recovery process.
Your pathologist may report a variety of atypical findings on a core needle biopsy. If you receive an atypical biopsy result, your doctor may recommend that you schedule an appointment at our high-risk breast cancer clinic to discuss risk-reducing strategies.
Atypical ductal hyperplasia (ADH) is a pre-cancerous condition that occurs when some, but not all, changes resemble breast cancer. ADH is found in about 6 percent of biopsies of suspicious tissue identified during a MRI. If ADH is found, your doctor may recommend surgical excision of a small amount of additional tissue because there is a 20-35 percent chance that cancer could be present.
Atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) are not cancer, but are markers of increased risk of developing cancer in either breast. If you have ALH, your doctor may recommend six-month follow-up or surgical excision. For LCIS, your doctor may recommend surgical excision of additional tissue at that spot.
Your radiologist will need to determine if your imaging results match with the pathology results. Most of the time, you can return to routine screening after a benign result on core needle biopsy. However, a repeat biopsy or surgical excision may be recommended in certain cases.
When you choose UPMC for MRI-guided breast biopsy, you will receive:
By UPMC Editorial Staff. Last reviewed on 2025-08-28.
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