Breast biopsy - open

Answer 1

Definition

A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders. Several different types of biopsy may be done. This article discusses open breast biopsy. An open biopsy involves making a small cut in the breast and removing breast tissue.

See also:

• Breast biopsy - stereotactic
• Breast biopsy - ultrasound
• Lumpectomy

Alternative Names

Biopsy - breast; Open breast biopsy

How the test is performed

An open biopsy is done as an outpatient procedure.

The biopsy may remove part or all of the lump or area of interest. If the entire lump or area of interest is removed, this method may also be called a lumpectomy.

If the surgeon cannot easily feel the lump or cyst, a breast ultrasound, MRI, or mammogram may be used to find the growth before the biopsy. A needle or wire will be placed in the area during the imaging test. This will be left in to help the surgeon find the growth.

The biopsy will be done in an operating room.

• Usually, you will lie on your back for the procedure. You may receive local anesthesia to make you sleepy, or you may receive general anesthesia.
• A small surgical cut is made on the skin. The surgeon follows the wire or needle and removes the breast tissue around it.
• The sample is then sent to a lab to be examined under a microscope. This exam will make sure that the whole growth has been removed. It will take more time to get a final diagnosis.
• After the tissue sample is taken, the cut is closed with sutures. A dressing and bandage are applied.

If you receive general anesthesia, your vital signs (temperature, pulse, breathing rate, blood pressure) will be monitored for at least an hour after the procedure. Your health care provider may prescribe pain medication.

How to prepare for the test

The health care provider will ask questions about your medical history and perform a manual breast exam.

You must sign an informed consent form. You will need to have some blood tests done before the surgery.

If you are going to have anesthesia, you may be asked not to eat or drink anything for 8 - 12 hours before the test.

If you take medications (including aspirin or herbal medications), ask your doctor whether you need to stop taking these before the biopsy.

Tell your doctor if you may be pregnant before having an open biopsy.

Do not wear lotion, perfume, powder, or deodorant underneath your arms or on your breasts.

How the test will feel

After the test, the breast may be sore and tender to the touch for several days. If a surgical cut is made, your doctor may prescribe pain medication. Usually, the pain will be mild and easy to control with over-the-counter pain medicines.

You will probably go home the day of the procedure.

Do not do any heavy lifting for 24 hours after the biopsy. Do not take a shower for the first 24 hours.

Why the test is performed

A biopsy may be done if your health care provider is concerned about Breast cancer because of an abnormal mammogram or breast ultrasound, or a growth that was felt during a physical exam.

A biopsy must be done to find out for sure whether you have breast cancer. Cells from the abnormal area are removed and examined under a microscope.

Normal Values

A normal result means there is no sign of cancer.

Your doctor or nurse will let you know when you need a follow-up mammogram or other tests.

What abnormal results mean

A biopsy may identify breast conditions that are not cancer or precancer, including:

• Adenofibroma
• Fibrocystic breast disease
• Intraductal papilloma
• Mammary fat necrosis

It may also find precancerous breast conditions, including:

• Atypical ductal hyperplasia
• Atypical lobular hyperplasia

Several types of breast cancer may be found on a biopsy:

• Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
• Lobular carcinoma starts in parts of the breast called lobules, which produce milk.
• Paget's disease is a rare type of cancer that forms in the nipple area.
• Inflammatory breast cancer is a rare type of cancer that makes the skin over the breast look infected.

Depending on the biopsy results, you may need more surgery or treatment.

What the risks are

There is a slight chance of infection in the biopsy area.

Excessive bleeding is rare, but it may need draining or re-bandaging. Bruising is common.

You will have a small scar. Depending on the amount of tissue removed and how the breast heals, the appearance of the breast may be affected.

References

Abeloff MD, Wolff AC, Weber BL, et al. Cancer of the breast. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008: chap 95.

Whitman GJ. Ultrasound-guided breast biopsies. Ultrasound Clin. 2006;1:603-615.

Kim CH, Bassett LW. Imaging-guided core needle biopsy of the breast. In: Bassett LW, Jackson VP, Fu KL, Fu, YS. Diagnosis of Diseases of the Breast. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2005:chap 17.

Reviewed By

Review Date: 11/21/2011

Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.