1. What is a breast biopsy?
You may have a breast biopsy if you have been referred to a breast clinic to investigate a breast change.
A breast biopsy involves removing a small sample of breast cells or breast tissue. The sample is sent to the laboratory where it’s looked at under a microscope.
There are different types of biopsy. You will usually have a core biopsy, but sometimes you may have a fine needle aspiration (FNA) or another procedure. Having a biopsy does not mean you have breast cancer.
The doctor or nurse may use an or as a guide to help them pinpoint the area of breast tissue before the sample is taken, particularly if it’s very small or cannot be felt.
If you’re taking aspirin or blood-thinning tablets (anticoagulants), let the doctor or nurse know before having a core biopsy or FNA.
2. Core biopsy
What happens at a breast clinic appointment?
Learn about what happens at a breast clinic appointment, how you’ll get your results and where to find support.
A core biopsy (also called a core needle biopsy) uses a hollow needle to take a sample of breast tissue. Tissue can give more detailed information than cells.
You’ll have a local anaesthetic to numb the area. A small cut is then made in the skin and samples of tissue are taken with the biopsy needle.
Stereotactic core biopsy
You may have a stereotactic core biopsy if the area of concern can only be seen on a mammogram.
A sample of tissue is taken using a needle biopsy device connected to a mammogram machine and linked to a computer. Images of the breast are taken from 2 different angles. This helps find the exact position of the area to biopsy.
You’ll have a local anaesthetic and will be sitting or lying down on a specially designed examination couch.
It may feel a little uncomfortable as the mammogram plates are pressed onto the breast throughout.
After your biopsy
A small dressing or plaster is usually applied. You’ll be asked to keep this on for a day or so afterwards.
Sometimes very thin strips of adhesive tape are used to help the edges of the wound close.
Once the local anaesthetic wears off, your breast may ache. It may be bruised for the next few days or weeks.
You can take pain relief if the area is tender or painful. You’ll be given more information about this before you leave the clinic.
3. Fine needle aspiration (FNA)
FNA uses a fine needle and syringe to take a sample of cells.
You may have a local anaesthetic first to numb the area.
After the FNA, you may need to wear a plaster for a few hours over the site where the needle was inserted.
4. Other types of breast biopsy
Punch biopsy
You may have a punch biopsy if you have changes to the skin of your breast or nipple.
This involves taking a very small circle of tissue from the area.
You’ll be given a local anaesthetic before a tiny cutting device is used to take the sample. You’ll usually be asked to wear a small dressing or plaster afterwards.
Vacuum assisted biopsy
You may be offered a vacuum assisted biopsy if:
- A biopsy has not given a definite result and more breast tissue is needed to make a diagnosis
- The area of concern is difficult to target
This procedure takes a little longer than a core biopsy.
After an injection of local anaesthetic, a small cut is made in the skin. A special needle connected to a vacuum device is placed through this.
Using a mammogram or ultrasound as a guide, breast tissue is sucked through the needle by the vacuum into a collecting chamber. This means several samples of breast tissue can be collected without removing the needle.
Sometimes this procedure is used as an alternative to surgery to remove a whole area of breast tissue. This is called a vacuum assisted excision biopsy.
5. Inserting a metal marker
Sometimes if the area of concern is small or difficult to see on a mammogram or ultrasound, a small metal marker (or clip) is placed in the breast where the biopsy was taken.
This helps your doctor find the area again if you need another biopsy or surgery. The marker can be safely left in the breast and does not need to be removed, even if you don’t need any more procedures.
The marker is usually made of titanium, the same metal used for joint replacement surgery. It will not set off alarms at airports.
Many markers are now suitable for having an MRI. However, if the marker is left in and you need to have an MRI scan in the future, let your doctor or radiographer know.
6. Breast biopsy results
The breast clinic will let you know how and when you’ll get your results. They may ask you to come back for your results, or they may give them to you over the phone or by letter.
Core biopsy results
You may hear your results described as a letter and a number. “B” stands for “biopsy”.
Core biopsy results may be described as:
- B1: Normal breast tissue
- B2: Benign (not cancer)
- B3: Abnormal or uncertain but probably benign
- B4: Suspicious and possibly cancer
- B5: Cancer
Fine needle aspiration (FNA) results
You may hear your results described as a letter and a number. “C” stands for “cytology”, which means the study of cells.
FNA results may be described as:
- C1: Inadequate sample (not enough cells for diagnosis)
- C2: Benign (not cancer)
- C3: Unusual, abnormal or uncertain but probably benign
- C4: Suspicious and possibly cancer
- C5: Cancer
Understanding your results
Your specialist team will use the result to help them decide if you need more tests or treatments.
More tests are usually needed for a result showing B3/B4/B5 or C3/C4/C5, or where the findings of all the tests do not agree.
Waiting for biopsy results
Having investigations for a breast problem can be a worrying and stressful time.
If you’re anxious about your results or would like to talk through any concerns, you can call our free helpline – see below.
