What To Expect When You Need a Breast Biopsy

An annual mammogram is already anxiety-inducing for most women, even if they know what to expect. So, getting through a mammogram only to hear a radiologist say, “You need a biopsy,” can understandably cause anxiety to resurface with many questions to consider.

What is a biopsy? Why do I need a biopsy? Will it hurt? Does it mean I have breast cancer? More than one million women in the United States have breast biopsies annually.

“Even though it is a common procedure, it is often not something a woman knows about until they have to go through one,” said Stephanie Sims, MD, Medical Director at Catholic Health’s St. Catherine Diagnostic Imaging. “It can be very unsettling, so I always reassure them that we will work together to understand what happens next.”

Why do I need a core needle biopsy?

If a mammogram or ultrasound shows you may have a suspicious finding, a radiologist will recommend a core needle biopsy (core biopsy).

A core needle biopsy uses a hollow needle to remove a sample of tissue from the breast. It is the standard for diagnosing or ruling out breast cancer without surgery.

A core needle biopsy uses a thicker needle and removes more breast tissue than a fine needle aspiration (FNA). An FNA uses a thin, hollow needle and syringe to remove tissue for biopsy samples. Your radiologist may use an FNA if the suspicious area is a fluid-filled sac (cyst).

What does a core needle biopsy examine?

A core needle biopsy can examine a breast lump or suspicious area. The needle removes samples of breast tissue from the area in question. A core needle biopsy can help determine the type of tumor and whether the tumor will respond to hormone treatment.

How to prepare for a core needle biopsy

“When the core needle biopsy is scheduled, you will be given specific instructions to follow,” said Dr. Sims. “We want you to feel comfortable and not be anxious, so ask questions and voice any concerns.”

Some general guidelines that can help you prepare for your procedure include:

Eating a snack or light meal beforehand
Skipping deodorant or lotion to avoid ingredients getting visualized on imaging tests
Wearing a sports bra for extra support after the biopsy

Let your radiologist know if you are pregnant or may be pregnant. If the core needle biopsy does not provide a clear answer, you may need a surgical biopsy, a type of biopsy that requires general anesthesia, which can carry a small risk to a fetus.

Also, let them know if you are taking blood-thinning medication. They may adjust your medication before the biopsy to prevent excessive bleeding.

What to expect during a core needle biopsy

“Knowing what to expect before your biopsy can help calm your nerves and ensure the procedure goes smoothly,” said Dr. Sims.

The appointment will take about two hours, although the biopsy itself will go quickly.

A local anesthetic is injected to numb the area around the biopsy site to keep you comfortable.

Once the needle is inserted, a small amount of tissue is removed. You may feel a slight pressure while the samples are taken. Your radiologist will use breast imaging to help guide the needle to the suspicious area via mammography, ultrasound, or MRI guidance. Sometimes, they may use a vacuum-assisted biopsy device to remove a tissue sample.

After removing the tissue samples, a small metal marker (clip) is inserted to mark the biopsy site. If the biopsy shows cancerous cells, a radiologist can easily find the site to remove more tissue. You will not feel the clip, and it will not affect future imaging. Medical tape is placed over the biopsy site.

Follow-up care after a core needle biopsy

After the procedure, pressure is put on the biopsy site to prevent blood clots. You may feel soreness at the biopsy area for a few days after the procedure. To help with the discomfort, you can take over-the-counter pain relievers. You may also see normal bruising around the biopsy site. Avoid vigorous activity, and do not lift anything heavier than five pounds.

Your care team will give you further instructions on what to do after the biopsy and when to schedule necessary follow-up care. Follow their guidance closely.

You will likely need to keep your medical tape on for seven to 10 days after the procedure. Wear a sports bra for extra support and prevent hematomas (clotted blood pools).

Call your doctor immediately if you have any signs of infection, such as redness or pus, as it may mean you need medical treatment.

Keep the biopsy site clean and dry for 24 hours to prevent infection. You can take a shallow bath the day of your biopsy and shower 24 hours after the biopsy. You can also remove your bandage 24 hours after the biopsy. The medical tape will usually fall off on its own after three days; if not, you can remove it yourself.

“We typically tell patients they can return to work and resume regular activities immediately after the procedure,” said Dr. Sims. “However, some patients choose to rest the day of the procedure.”

Next steps after a core needle biopsy

Dr. Sims explained that you usually get your core needle biopsy results within a week or less. Your care team will review the results with you and explain their meaning.

Results include: