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All You Need To Know About Breast Biopsies

Medically reviewed by Dr. Tan Chuan Chien, Consultant General Surgeon (Breast & Thyroid Surgery)

A breast biopsy is a minimally invasive procedure that involves extracting a tissue sample from a suspicious lump or abnormality detected through imaging. It helps determine whether the lesion is benign or cancerous, providing information to guide further treatment. This article aims to provide a comprehensive overview of breast biopsies.

Why Is a Breast Biopsy Recommended?

A breast biopsy is recommended when imaging tests, such as a mammogram, ultrasound, or MRI, detect a lesion or abnormality that requires further examination. Because imaging alone cannot always determine if an abnormality is benign (non-cancerous) or malignant (cancerous), the biopsy provides a definitive diagnosis and helps guide appropriate treatment.

Common Reasons for a Breast Biopsy

A breast biopsy is typically recommended when specific signs, symptoms, or imaging findings suggest further examination is necessary. Common indications include:

Abnormal Imaging Results: Suspicious findings such as lumps, masses, or calcifications detected through mammograms, ultrasounds, or MRIs may require biopsy confirmation.

Lumps or Tissue Thickening: A noticeable lump or thickened area identified during a clinical breast exam that feels different from surrounding tissue may indicate the need for further evaluation.

Unexplained Nipple Changes or Discharge: Symptoms such as bloody discharge, inverted nipples, or skin dimpling can suggest an underlying abnormality that requires investigation.

Changes in Breast Texture or Skin: Redness, swelling, scaling, or skin thickening may indicate inflammatory conditions or cancer, prompting the need for a biopsy.

What to Expect During a Breast Biopsy

Preparing for the Procedure

Initial Consultation

Your surgeon will explain why the biopsy is necessary based on your imaging results and what the procedure aims to determine. You will receive a detailed overview of the process, including the type of biopsy performed and what to expect before, during, and after. This is also an opportunity to ask questions, express concerns, and discuss how the results will influence your treatment plan.

Medication Review

Bring a list of all the medications, supplements, and vitamins you take regularly to your appointment. Certain blood-thinning medications, such as aspirin, Plavix, or warfarin, may need to be paused temporarily to minimise the risk of bleeding.

Sedation Option

While most breast biopsies are performed under local anaesthesia, you can discuss the possibility of sedation with your surgeon. Your surgeon will assess your health history and any risks to determine if sedation is suitable.

On the Day of the Procedure

If you are not receiving sedation, you can eat light meals, but avoid heavy food before the procedure. Wash your breasts and armpits with soap and water, and do not apply deodorant.

Step-by-Step Procedure

Anaesthesia Administration

Local anaesthesia will be injected to numb the area, ensuring you feel minimal discomfort during the biopsy. If sedation is used, it will be administered before the procedure to help you relax or remain asleep through the process.

Imaging Guidance

The surgeon will use imaging techniques such as ultrasound, mammography, or MRI to accurately locate the lesion. This guidance ensures the biopsy needle is precisely inserted into the correct area for an effective tissue sample.

Tissue Extraction

A thin biopsy needle will be inserted into the target area to extract a tissue sample for laboratory analysis. If a vacuum-assisted biopsy is used, it collects a larger tissue sample, improving the accuracy of the diagnosis.

Bandage Application

Once the biopsy is complete, the doctor will apply firm pressure to the site to control bleeding and reduce swelling. A bandage or dressing will then cover the area to protect it and promote healing.

Post-Procedure Monitoring

You will be monitored for a short period to ensure there are no immediate complications, such as excessive bleeding or allergic reactions. If sedation was used, you will be observed until the effects wear off.

After Your Breast Biopsy: Care Instructions

Bandage Care

The bandage will remain on the biopsy site to minimise swelling and prevent bleeding. Your surgeon will provide instructions on when and how to remove it safely and how to care for the site.

Pain Management

You may experience some soreness or discomfort after the procedure. Over-the-counter pain relievers, like acetaminophen, are often enough to manage discomfort.

Transportation Arrangements

If you received sedation, the sedative effects may impair your ability to drive or perform tasks that require focus. Make sure someone is available to take you home safely after the procedure.

Follow-Up Appointment

A follow-up appointment is typically scheduled within five days after the biopsy to discuss the results. Your surgeon will explain the findings and, if needed, outline the next steps for your treatment plan.

Possible Risks and Side Effects

Breast biopsies are generally safe, but some patients may experience mild pain, swelling, or bruising at the biopsy site. Infections and bleeding can occasionally occur, though these are uncommon and typically manageable. Following your surgeon’s aftercare instructions helps reduce the risk of complications and ensures proper healing.

Conclusion

A breast biopsy is a necessary diagnostic tool that helps determine whether a lesion is benign or cancerous, guiding the next steps in treatment. With proper preparation and post-procedure care, the process is typically safe and straightforward.

If you have any concerns or need further evaluation, consult Dr Tan Chuan Chien, our Breast Specialist to discuss your options and ensure timely care.

Frequently Asked Questions (FAQs)

Will a breast biopsy spread breast cancer?

When performed by an experienced surgeon, the chance of a breast biopsy spreading cancer is extremely low. The procedure is safe, minimally invasive, and necessary for determining the nature of the lesion and developing an appropriate treatment plan.

Does a breast biopsy remove the entire lesion?

No, a breast biopsy only removes a small sample of the lesion, not the entire lump or mass. This sample is then sent to a laboratory, where it is carefully examined to determine if the lesion is benign or cancerous. The goal is to collect enough tissue to provide a reliable diagnosis without removing the whole lesion.

How long does a breast biopsy procedure take?

The entire breast biopsy procedure typically lasts between 30 and 60 minutes. Additional time is required for preparation, as well as a brief observation period following the procedure. Patients should allow for 1.5 to 2 hours at the clinic.

As a supporter of personalised surgical care, I understand that no two patients are the same. I believe in tailoring management for each patient to meet each individual’s needs and expectations. A patient’s journey can be difficult and frustrating at times, so I strive to make this experience as pleasant and seamless as possible.

Dr. Tan Chuan Chien

Dr. Tan Chuan Chien

Consultant General Surgeon Breast & Thyroid Surgery
  • Bachelor of Medicine & Bachelor of Surgery (MBBS)- The University of Adelaide, Australia
  • Fellow of the Royal Australasian College of Surgeons (FRACS)
  • Full Registration, Singapore Medical Council (SMC) and Specialist Accreditation Board, Singapore (General Surgery)
  • Full General & Specialist Registration (General Surgery), Australian Health Practitioner Regulation Agency (AHPRA)
  • Completed Breast Surgery training through the BreastSurgANZ Fellowship programme
  • Fellow of the Academy of Medicine, Singapore (FAMS)

Dr. Tan Chuan Chien is a Fellowship-trained Breast and Endocrine Surgeon practicing as a Consultant General Surgeon at Gleneagles Hospital, Singapore. He also sees patients at Mount Elizabeth Novena Specialist Centre and Parkway East Medical Centre. Dr. Tan is a registered Specialist Surgeon (General Surgery) in both Singapore and Australia.

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