Procedures to Evaluate Breast Lumps, Masses and Calcifications

Several procedures can be used to evaluate breast lumps, masses and calcifications.

Fine Needle Aspiration
This procedure is used to biopsy abnormalities identified on physical exam, mammography, or ultrasound. Ultrasound may be used as an aid to guide the position of the needle. The area where the needle will be inserted is cleaned with an antiseptic in order to destroy bacteria. A very small needle attached to a syringe is inserted into the area of concern, and suction is applied to remove cells. The cells are sent for pathology studies. The procedure will leave no scarring, and you can return to your normal activities the same day.

No preparation is necessary.

Core Needle Biopsy

If a lump is found through examination, mammography, or ultrasound, a core needle biopsy may be used to diagnose the abnormality. The needle has a large center that removes a core of tissue from the lump. Core biopsies may be used with imaging to guide the physician to the suspicious area. The procedure is performed in the Breast Center.

The skin where the needle will be inserted is cleaned with an antiseptic in order to destroy bacteria. The area is then numbed by injecting an anesthetic agent through a small needle. The physician locates the lump and stabilizes it to prevent movement as the core needle is inserted. Since the needle is large, you will feel pressure as the physician inserts the instrument. The needle removes a core of tissue, which is sent to the pathology lab for evaluation. The pathologist informs your physician of the results of the biopsy, whether it is benign or malignant. Ask your physician when and how you can expect to receive the biopsy results.
The procedure takes about 15 minutes. No preparation necessary. When completed, a small bandage will be placed on your breast and you can return to your normal activities within 2 days. You may shower the day following your biopsy.

Occasionally a hematoma (i.e. blood collection) may form at the site following the procedure, and may cause a palpable, painful lump. This complication occurs from the rupture of a small blood vessel in the breast during the procedure. If a hematoma occurs, please inform the radiologist that performed the procedure, or your referring physician.

Wire Localization

This procedure is performed on areas found on mammography or ultrasound which are difficult to feel. The breast is cleansed with an antiseptic. Using mammography or ultrasound for guidance, a fine wire or other localization device is inserted into the identified area. Following the procedure, a mammogram confirms the correct placement of the wire/device. If a wire is used, the localization wire is taped to the breast and the patient is transferred to surgery. The surgeon uses the wire as a guide to find the area for biopsy. The tissue removed is sent to pathology. Activities may be limited for several days until the area heals.

No preparation necessary.

Stereotactic/Tomosynthesis Biopsy

This procedure is performed on a suspicious area identified on a prior mammogram. The patient lies face down on a biopsy table with the breast hanging through an opening in the table. The breast is first cleaned with an antiseptic. It is compressed and then numbed with a local anesthetic. Stereotactic mammography imaging equipment locates the lesion using a computer and images taken from two different angles. The physician then uses the computer coordinates to guide the sampling biopsy needle device to the correct area of the breast. The biopsy specimen is then sent to pathology. Occasionally a hematoma (i.e. blood collection) may form following the procedure, and may cause a palpable, painful lump. This complication occurs from the rupture of a small blood vessel in the breast during the procedure. If a hematoma occurs, please inform the radiologist that performed the procedure, or your referring physician.

No preparation necessary.

Surgical Biopsy
A surgeon removes a portion of the abnormal area in a surgical suite. Local or general anesthesia will be used. A short time in the recovery room is required after the surgery. Stitches close the incision. The specimen is sent to the pathologist. Activities will be restricted until stitches are removed or dissolved. Patients should contact their surgeon for specific preparation instructions.