Understanding Your Breast Biopsy Options at UPMC in Central Pa.

Not every abnormal mass in your breast is cancer. Sometimes, through an ultrasound or MRI, your doctor will be able to determine with certainty that an unusual growth is benign and not likely to harm you.

However, should your doctor need more information to make a firm diagnosis, he or she will likely send you for a breast biopsy.

A breast biopsy is a procedure that is used to obtain a tissue sample from an abnormal mass. This tissue is then sent to a lab where it is studied under a microscope by a pathologist who determines if it's benign or cancerous.

If the mass is malignant (or cancerous), the pathologist will characterize it by type, abnormality (grade) and whether or not it has spread outside the milk ducts or lobules of the breast where it started. The pathologist will also test the tissue for receptors such as hormone receptors (estrogen and progesterone receptors) and HER2 neu status. Depending on the results, additional specific treatments may be available.

UPMC Breast Care Center offers several types of breast biopsy procedures. These vary in both the way that they are performed and the amount of tissue that is removed. Your doctor will decide which biopsy is most appropriate for you.

Types of Breast Biopsy

• Fine needle aspiration (FNA). During this minimally invasive procedure, the surgeon inserts a very thin needle into the area of the breast where the mass is located. Tissue is withdrawn from the affected area for testing. This approach is quick and discomfort lasts only a few minutes.
• Core needle biopsy. This approach may be used if a larger tissue sample is needed for testing. Core needle biopsy is performed under local anesthetic and uses a larger, hollow needle to remove a thin cylinder of tissue.
• Image-guided biopsy. If the suspicious area can’t be felt, then a radiologist can use diagnostic imaging techniques (ultrasound, stereotactic mammographic imaging or MRI) to guide the needle to the appropriate location.
• Surgical biopsy. If other biopsy approaches don’t provide a definitive diagnosis, a surgical biopsy may be performed. This procedure is also used if the suspicious area is too deep or superficial for the other types of biopsies.