Being asked to return for further testing after a mammogram can feel frightening, but it’s common. About 1 in 10 mammograms result in a callback for further testing, according to Johns Hopkins Medicine, but most breast biopsies don’t lead to a cancer diagnosis. A breast biopsy is a test that uses a small sample of breast tissue to look for signs of cancer.

In this article, we’ll explain what a breast biopsy is and when it may be needed. We’ll also cover what to expect before, during, and after a breast biopsy.

🗳️ What type of biopsy did you have after a mammogram?

Needle biopsy

Surgical biopsy

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Types of Breast Biopsies

Your healthcare provider will recommend a specific type of breast biopsy based on your mammogram findings and any new symptoms.

Needle Biopsy

A needle biopsy is a less invasive procedure than other types of biopsies. During a needle biopsy, the radiologist places a needle through the skin into the area being examined and removes a sample for testing. The way the sample is collected depends on the type of needle biopsy.

The two types of needle biopsies are:

• Fine-needle aspiration — The doctor uses a thin needle attached to a syringe.
• Core needle biopsy — The doctor uses a larger needle with a spring-loaded or vacuum device.

During a needle biopsy, the doctor may use a mammogram or MRI to guide the needle to the exact spot of concerning tissue. Biopsies that use mammogram guidance may be referred to as stereotactic biopsies.

Surgical Biopsy

A surgical biopsy is more invasive and takes place in the operating room. A surgeon or radiologist will numb the area and make an incision in the skin to remove a small tissue sample.

The types of surgical biopsies include:

• Incisional biopsy — The surgeon removes part of the suspicious area.
• Excisional biopsy — The surgeon removes the entire suspicious area (also called a lumpectomy).

What To Expect During a Breast Biopsy

A breast biopsy is a relatively quick procedure. The time needed for a breast biopsy depends on the type. The actual tissue collection may be brief, but preparation, imaging, and recovery can make the entire process take longer.

Before a Breast Biopsy

When your doctor orders a breast biopsy, they’ll talk with you about what to expect and how to prepare. It’s important to tell them if you could be pregnant and any medications you’re taking. Tell your doctor if you’re taking any blood-thinning medications, because they may need to adjust your medication before the test.

When you arrive for your biopsy appointment, you’ll check in with the clinic or hospital. The healthcare provider who takes you back will review your current medications and any allergies. They may ask you to use a wipe to remove your deodorant if you’re having a mammogram-guided biopsy.

When the doctor comes into the room, they’ll explain the procedure to you and ask if you have any questions. To get started, the doctor will determine the exact location in your breast for the biopsy.

Locating the Biopsy Site

For a needle biopsy, the doctor may use an imaging test to find the right area and guide the needle. They may use a mammogram, ultrasound, or MRI. These imaging tests are noninvasive and don’t hurt.

Before a surgical biopsy, your surgeon may use a wire to find the biopsy location. This involves numbing the area, then using a hollow needle to place a wire inside the breast tissue using ultrasound or MRI guidance. After the test is over, the surgeon will remove this wire.

Another way surgeons locate a biopsy site is with tiny devices placed inside the breast. Your surgeon may place pellets or reflectors in your breast tissue before surgery. During surgery, a handheld detector can help locate the device and guide tissue removal.

During a Breast Biopsy

Once your doctor determines the exact location for the biopsy, they’ll perform the test. Either the doctor performing the biopsy or an anesthesiologist will numb the area first.

For a needle biopsy, the doctor will give you local anesthesia. This involves inserting numbing medication into the tissue with a small needle. For a surgical biopsy, you may receive general anesthesia. If you do, you’ll be asleep for the procedure and shouldn’t feel anything.

During a fine-needle aspiration, the doctor will insert a small, hollow needle into the breast and pull back on the syringe to remove cells and fluid. For a core needle biopsy, the doctor will make a small cut in the skin, then insert a larger hollow needle. This type of biopsy uses a spring-loaded or vacuum device to obtain a larger sample.

The Biopsy Experience

It’s common to hear sounds during your biopsy. A loud snap or popping sound can come from the biopsy needle being deployed. A vacuum-assisted device for a core needle biopsy may make a drilling sound.

It can be difficult to predict how much pain you’ll experience during a biopsy, since pain is subjective and different for everyone. Most people experience a feeling of pressure, rather than pain. Tell the doctor if you’re uncomfortable during the procedure.

The actual tissue collection may take only a minute or two. However, the entire process can take hours to check in, find and numb the right area, and take images with a mammogram, ultrasound, or MRI.

After a Breast Biopsy

After a breast biopsy, you may feel sore and have a small amount of bleeding or bruising. People who have fine-needle biopsies will likely have a minimal amount of bleeding, but core needle biopsies can cause more. Bruising from a core needle biopsy may take several weeks to fade.

Most people feel better and can return to their normal activities about a day after a fine-needle aspiration biopsy. Plan to rest and avoid strenuous activity for a couple of days after a core needle biopsy. For a surgical biopsy, it could take a week before you feel fully recovered.

Possible risks of a breast biopsy include:

• Pain
• Bleeding
• Bruising
• Infection

It’s rare to have any serious complications from a breast biopsy, but it’s helpful to know the signs. Call your doctor if you develop any of the following symptoms:

• A fever over 101 degrees Fahrenheit
• Painful swelling
• Bleeding that doesn’t stop
• Shortness of breath

What Happens Next?

It can take about one to two weeks for your biopsy results to come back. This is often a stressful time. Take time to relax if you can. Share your concerns with friends and family and reach out to your doctor with any questions while you wait. If your results come back cancerous, your doctor will call you to discuss next steps.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Have you ever had a breast biopsy? Which type? Let others know in the comments below.