Understanding my biopsy

A biopsy is when a sample of cells or tissue is taken so that they can be examined under the microscope. The majority of breast lumps are benign (non-cancerous) however it is sometimes necessary to take a biopsy to confirm the diagnosis of what has been seen on scans.

If a biopsy is required, this will be explained to you. The biopsy results, typically, takes a couple of weeks and you may need a follow-up appointment to discuss them.

There are four sorts of biopsies that are carried out in Breast Care:

• fine needle aspiration cytology
• core biopsy
• skin punch biopsy and vacuum biopsy
• .

These procedures carry a small risk of complications and we take steps to minimise the risks. Most people will get some bruising after their biopsy. The commonest complication after a biopsy is bleeding, which may result in a haematoma (small collection of blood), so if you have a clotting disorder (such as haemophilia) or take any medications that may increase your risk of bleeding you should tell us. This may include rivoroxiban, apixiban, warfarin, aspirin, ticagrelor or clopidogrel.

Fine needle aspiration cytology

Fine needle aspiration cytology is where a needle and syringe are inserted into the area of concern and a cell sample is taken. These are then sent to the pathologist to be examined under the microscope.

Core biopsy

This method is designed to take cells from the center of a lump. Core biopsy is a procedure where an injection of local anaesthetic is used to numb the skin before a needle is introduced through a small cut in the skin. Once the needle is in the appropriate targeted area, the biopsy is taken - there is a loud click as this is being done, as the biopsy needle is spring-loaded. Several core biopsies may need to be taken to get a representative sample. These are then sent to the pathologist to be examined under the microscope.

Skin punch biopsy

Skin punch biopsy is used when a concerning area is on the skin of the breast rather than the underlying breast tissue. This biopsy is done after an injection of local anaesthetic to numb the skin. A small circle of skin is then removed and is sent to the pathologist to be examined under the microscope.

Vacuum biopsy

This type of biopsy is rarely done on the first visit and it will be explained if it is needed. It is usually done when an initial biopsy has not produced enough tissue for the pathologist to make the diagnosis. Sometimes vacuum biopsy can be used to remove small abnormalities completely. In each case, all the tissue removed is then sent to the pathologist to be examined under the microscope.

Vacuum excision

This is performed by our Consultant Radiologist as per the guidelines for atypical lesions.