A surgical biopsy is the most accurate way to diagnose breast cancer and get complete information about the tumor.
Core needle biopsy is accurate in diagnosing cancer and does not involve surgery, so it is often the preferred biopsy method (learn more) . Some people, however, need a surgical biopsy.
The tissue removed during a biopsy is tested for signs of cancer. If cancer is found, other tests can be done to help you and your health care provider plan treatment.
Learn more about these tests.
Most surgical biopsies are excisional biopsies. With an excisional biopsy, the whole abnormal area (plus some of the surrounding normal tissue) is removed.
In certain cases, an incisional biopsy is done. This procedure only removes part of the tumor. An incisional biopsy is only done if a tumor is too large to be removed with an excisional biopsy.
Today, few people have an incisional biopsy.
An excisional biopsy (sometimes called a lumpectomy) is done by a surgeon in an operating room. The surgeon will use local anesthetic to numb the area that will be biopsied and you will also get IV sedation (rather than general anesthesia).
You probably won't need to stay overnight in the hospital.
Before surgery, a wire-localization or needle-localization procedure is usually done if the abnormal area in the breast was first detected on imaging tests (such as a mammogram) and cannot be felt.
During this procedure, a radiologist uses a mammogram or breast ultrasound image to guide a very thin wire into the suspicious area of the breast. The surgeon then uses this wire to find the area during surgery.
In these cases, the breast tissue that is removed is usually X-rayed. This lets the surgeon and radiologist match the suspicious areas on the mammogram with those in the biopsy tissue. If the areas match, the correct tissue was removed. If the areas do not match, the surgeon may try again to remove the correct tissue or may wait to do another biopsy.
Although the goal of an excisional biopsy is to diagnose cancer, sometimes the surgeon may be able to fully remove the cancer. In these cases, excisional biopsy may be the only breast surgery needed to treat the cancer. For others, lymph nodes may also need to be removed in a second surgery at a later date.
Learn how biopsy tissue is preserved for a pathologist’s exam.
Learn more about breast cancer treatment.
If the biopsy shows cancer, a pathologist will study all the tissue removed during surgery to determine whether there is a wide enough rim of normal tissue around the tumor. This rim (called a margin) helps show whether or not all of the tumor was removed.
Learn more about tumor margins.
Excisional biopsy is accurate and gives few false negative results.
A pathologist’s exam of the biopsy tissue gives information that helps plan treatment, including:
Learn more about these factors.
In some cases, excisional biopsy is the only surgery needed to remove the tumor.
An excisional biopsy has some drawbacks. It is a surgery, so compared to a needle biopsy:
The amount of tissue removed during an excisional biopsy can also change the look and feel of the breast.
If the biopsy results are benign (not cancer), then more surgery may have been done than was needed.
An incisional biopsy is similar to an excisional biopsy, but less tissue is removed.
The surgeon uses a local anesthetic to numb the area and you will also get IV sedation (rather than general anesthesia).
Since incisional biopsy only removes part of the tumor, more surgery may be needed to remove the remaining cancer.
Breast Cancer 101: Surgical Biopsy
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