Breast Biopsy Information

Breast biopsies can be performed for solid masses or calcifications; occasionally symptomatic cysts will be aspirated with ultrasound guidance. With ultrasound guidance, we use a spring-loaded needle for biopsy, and with stereotactic (x-ray) guidance we employ a vacuum-assisted needle. Usually prior to biopsy you will have a full work-up with mammography and possibly ultrasound and breast exam.

Preparation: You should avoid eating for at least two hours prior to biopsy. Avoid taking any medications which affect clotting for five days prior to biopsy. These include aspirin, Motrin, Advil, Naproxen, Indocin, Alleve, coumadin, lovenox, Ticlid, and Plavix, which can all cause bleeding after biopsies. Do take all other routine medications on the day of biopsy.

Ultrasound Core Biopsy: This biopsy is generally performed for solid masses visible with ultrasound, since this is the quicker and more comfortable procedure. You will lie on your back on the table, and, after we image the nodule with ultrasound, we clean the breast with iodine and place a sterile drape. After numbing the site, we make a small skin nick. A needle will be placed through the nick for biopsies, usually three to six samples. The whole procedure usually takes 15 to 30 minutes and should not be painful. A pinching sensation at the time of biopsy is normal; if you experience any significant discomfort, tell the physician.

Stereotactic Core Biopsy: This is generally performed for calcifications or masses not accessible with ultrasound. For this procedure you will lie on your stomach with your breast through a hole in the table. Your breast will be compressed as for mammography, and the area localized with x-rays. With this procedure, localization is very precise, so you should lie still on the table. The table can be uncomfortable particularly to the neck, so let the technologist work with you initially to make you as comfortable as possible. After localization, we clean the breast with iodine, numb the area, and make a small skin nick. The needle is inserted once, and numerous samples are obtained with rotation of the needle. The procedure usually takes 30 to 45 minutes and should not be painful. A pinching sensation at the time of biopsy is normal; if you experience any significant discomfort, tell the physician.

Risks: Risks of biopsy are predominantly bleeding and infection. A small amount of bruising at the biopsy site is common. Occasionally, deeper bleeding can cause pain or swelling the day of biopsy. If that occurs, put firm pressure over the site, and, if symptoms do not resolve, call us in the department. Infection is quite rare but can occur several days after biopsy and cause pain, redness, or fever. If these occur, we will see you for evaluation and usually prescribe antibiotic treatment.

Post Biopsy: You should avoid vigorous activity and avoid immersing the biopsy site in water for three days. You may, however, shower over the site on the day after biopsy. We will call you with biopsy results usually within three days. If you do not receive the results by the third day, call us in the department.

Contact Us: Contact any of the biopsy radiologists or staff through the breast coordinator at Oakland: Elaine Monney (510) 752-2414, Richmond: Kasi Godfrey (510) 307-2336, or call the main department (510) 752-1255.

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