If you or your doctor discovers something unusual in your breast—such as a lump, discharge or unusual skin changes, like peeling around the nipple—a breast biopsy may be in order to help identify the cause.
“There are many patients who have an abnormal mammogram or find something themselves during a self-breast exam, which may warrant a biopsy,” says Anees Chagpar, MD, MPH, a Yale Medicine surgical breast oncologist at the Breast Center at Yale Cancer Center and Smilow Cancer Hospital.
Yale Medicine doctors use the latest techniques and advanced technology to perform breast biopsies. And, if needed, our comprehensive breast program provides care in a safe and compassionate environment.
What is a breast biopsy?
A breast biopsy is a procedure in which a small piece of tissue is removed and sent to a pathology lab to be evaluated under a microscope to determine if it is malignant (cancerous) or benign (non-cancerous). “Just because you’re having a breast biopsy doesn’t mean you have cancer,” says Dr. Chagpar. Eighty percent of the time, women who have a biopsy don’t have breast cancer, which is helpful to keep in mind if you or your loved one is scheduled for a breast biopsy
What kinds of breast biopsies are done here at Yale Medicine?
There are four main kinds of breast biopsies:
Fine needle aspiration (FNA): This technique is used when a lump or mass can be felt. With FNA, a doctor uses a small needle to remove some cells. This sample is then sent to a pathologist for examination under a microscope in order to determine if the cells are cancerous or non-cancerous.
Core needle biopsy: This 30- to 60-minute procedure is done by a radiologist using a local anesthesia. A core needle biopsy is useful for gathering a larger amount of tissue than a FNA. Your doctor may use imaging such as ultrasound, mammogram or MRI to help guide this procedure. When it is done using a mammogram for guidance, it is called a “stereotactic biopsy.” The biopsy site will usually be marked with a small, metal clip which is left in place so that the area can be identified later.
Excisional biopsy: This minor surgical procedure may be required if the abnormality cannot be sampled with a core needle biopsy, or a larger sample is needed to obtain a definitive diagnosis. Excisional biopsy, involving an incision into the breast to remove abnormal tissue, is often done under a light or “twilight” anesthesia. A “guide wire” is sometimes used to mark where tissue is to be excised if the surgeon cannot feel the lesion that needs to be removed. In this case, the procedure may be called a “wire-localized” or “needle localized” excisional biopsy.
Punch skin biopsy: When a breast abnormality is found on the skin surrounding the breast or nipples, this technique is used to sample the affected skin cells. It is performed in a surgeon’s office. Local anesthetic numbs the skin and then a small piece removed using a punch biopsy tool. The surgeon will then stitch the area and send the sample to a pathology lab for evaluation.
What makes Yale Medicine’s approach to breast biopsies special?
If you or a loved one requires surgery as a result of breast cancer, you should feel confident in the skills and experience of our nationally and internationally renowned specialists and breast cancer surgeons.
Our breast surgeons and interventional oncologists are experienced with some of the most complex breast cancer cases. We offer minimally invasive procedures, clinical trials and innovative oncoplastic techniques, including the DIEP flap procedure.
Our breast experts at The Breast Center at Smilow Cancer Hospital at Yale New Haven offer a comprehensive breast program where you can get all your imaging, have your biopsy, and then meet with your team of specialists in the same place in a coordinated fashion,” Dr. Chagpar says.