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A core biopsy is where a special needle is inserted into the breast or lymph node to take a small sample of tissue from an area of concern so that it can be sent to a laboratory for testing.
If an abnormality in the breast cannot be felt as a lump, the radiologist will use ultrasound or breast X-ray images or pictures (mammograms) to ensure the needle is placed exactly in the correct position. Occasionally, the doctor may position the needle with the help of images taken with a MRI machine. Once the needle is in the correct position, several small tissues samples are taken from the area where the abnormality has
been identified.
You may be referred for a needle biopsy under the following circumstances:
Generally, no preparation is needed. You should bring any recent breast imaging (mammograms and/or ultrasounds) and reports for the doctor carrying out the procedure to review before doing the biopsy.
Do not wear talcum powder or deodorant on the day of the biopsy. It is better to wear a two-piece outfit, so you only need to undress from the waist up.
The skin of the breast is washed with antiseptic and then a very fine needle is used to give local anaesthetic to numb the breast in the area for biopsy. The local anaesthetic stings for only a few seconds when it is being given, and after this the area will be numb.
A small cut (approximately 2 mm) is made in the skin and the biopsy needle is gently inserted into the breast. Several small samples are taken. When each sample is taken there is a clicking noise, and you may have a feeling of pressure in the breast where the sample is taken. The biopsy procedure may sometimes feel uncomfortable, but is not usually painful because of the local anaesthetic that has been given. After the samples have been taken, the biopsy area will be pressed on firmly for a few minutes to reduce bruising and bleeding, and then covered with a dressing. The small cut heals normally and you will not require stitches.
The area that has been biopsied may feel a little tender for several days and there is usually some bruising. If the biopsy area is painful, you can take simple pain killers; for example, paracetamol. Medicines containing aspirin are not recommended, because aspirin thins the blood and can increase bruising or bleeding at the biopsy site. You should avoid vigorous physical exercise or heavy lifting for 24 hours after the procedure, as this may make the bruising worse.
The small skin cut that was made for the biopsy usually heals over in a few days and you will have a tiny scar less than 5 mm in size that will be barely visible once healed.
The time taken for the procedure varies according to how the biopsy is done. For example, an ultrasound-guided core biopsy may take only 20 minutes. A mammography-guided core biopsy (also called a ‘stereotactic breast biopsy) may take up to an hour.
You will usually have some bruising at the biopsy site and sometimes this may take several weeks to disappear. There is a very small risk of infection. In the very unlikely event that the biopsy site becomes infected, a course of antibiotics may be required from your doctor.
Contact your doctor if you experience excessive swelling, or bleeding, have fluid draining from the wound, redness or heat in the breast after the biopsy.
If the area of concern is located deep within the breast next to the chest wall, there is a slight risk that the biopsy needle could pass through the chest wall, allowing air around the lung that could collapse a lung. This complication is a very rare occurrence and is called a pneumothorax.
If there is an area of concern in your breast, the core biopsy will be used to take samples of this area, so that a pathologist can examine it and make a diagnosis. It is a way of gaining accurate information without needing an operation to surgically remove the tissue for testing.
A breast core biopsy is usually carried out by an experienced specialist doctor, such as a radiologist, breast surgeon, breast physician or pathologist. If the area of concern cannot be felt as a lump, then the core biopsy is done using ultrasound or mammography to guide the biopsy needle into the correct position.
This will depend on the specialist doctor doing the test. Most core biopsies of the breast are carried out by a radiologist using ultrasound or mammography guidance, and so are done in a hospital radiology department, breast clinic or private radiology facility.
The samples are sent to a pathologist and examined under a microscope. The pathologist provides a detailed report that is sent to the doctor who has requested your core biopsy (this could be your family doctor, a breast surgeon or a breast physician). Usually, your doctor will already have made arrangements to discuss the results with you. The pathology results are usually available and sent to your doctor within a few days.
*At Perth Medical Imaging, biopsy referrals are reviewed on a case by case basis by our specialist Radiologist, and will only proceed if the performance of biopsy at our centre is in your best interests.
