Downloadable Procedure Forms & FAQs
See Also
Prebreast Needle Biopsy Questionnaire
Breast Needle Biopsy Instructions
Instructions for Image-Guided Breast Biopsy
Post Image-Guided Breast Biopsy Care Instructions
Consent to Operation, Procedure and Administration of Anesthesia
- Why is a biopsy performed?
- How is a biopsy performed?
- What risks are involved in performing a biopsy?
- How should I prepare and what medications should I avoid for the biopsy?
- How do I take care of my biopsy site?
- How and when do I get my biopsy results?
- What do I do if there is bleeding at my biopsy site or other complications?
- Can I go back to work after my biopsy?
- What kind of follow-up do I need after my biopsy?
1. Why is a biopsy performed?
During a mammogram, breast ultrasound or breast MRI, an abnormality may be detected. This abnormality could be a lump or other irregularity seen upon imaging of the breast. It is not always possible to tell from these imaging tests whether an abnormality is benign or cancerous. In this setting a radiologist recommends a breast biopsy for further evaluation.
A breast biopsy involves removing a small sample of breast tissue for lab testing. Image-guided breast biopsy is not designed to remove the entire lesion, but most of a very small lesion may be removed in the process of the biopsy. The tissue sample is processed and then examined under a microscope to determine a diagnosis.
By looking at the breast tissue under a microscope, any abnormalities in the cells in the area of the abnormal imaging can be identified, helping to provide a diagnosis. Based on these results, your doctors can determine whether or not any further treatment, imaging, or additional surgery is needed.
The sampling of breast tissue can be performed in a number of ways – either surgically or through a less invasive procedure using a hollow needle. Image-guided biopsy is usually performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by hand (called palpation). During an image-guided breast biopsy, the radiologist samples the breast tissue in the area of the abnormality using imaging to guide the needle to the suspicious finding.
Image-Guided Breast Biopsies can be performed in a number of ways:
2. How is a biopsy performed?
Image-guided breast biopsy can be performed in a number of ways. Depending on the size, location, or other characteristics of the abnormality seen on breast imaging, the radiologist may recommend a specific method to perform the biopsy.
Image-Guided Breast Biopsies can be performed in a number of ways:
3. What risks are involved in performing a biopsy?
Please refer to the Breast Needle Biopsy Consent form for further information regarding the risks involved in stereotactic, ultrasound, or MRI guided core biopsies or ultrasound guided fine needle aspirations.
4. How should I prepare and what medications should I avoid for the biopsy?
If you are taking anticoagulants (blood thinners), such as Coumadin (Warfarin), Plavix, or Lovenox (heparin shots), please tell our nurse, Rosalind Benedet, RN, MSN (phone number 650-721-5419) that you are on these medications.
You should also consult your prescribing physician as to whether you can stop these medications, when you should stop these medications before your biopsy, and when you should resume them after the biopsy is completed.
If you are on Coumadin (Warfarin), you must have a PT/INR drawn the day before your scheduled biopsy. Please bring the results with you if you have this lab drawn outside of Stanford. Your biopsy may be cancelled if these steps are not taken.
Please notify our nurse, Rosalind Benedet, RN, MSN (phone number 650-721-5419) if you have any of the following so we may arrange for alternatives:
- Bleeding problems or a known bleeding disorder
- Allergy to local anesthetic
- Allergy to tape, latex, or Chlora-prep (sterile alcohol-based cleaning solution)
- Rapid heartbeat with anesthetic used at dentist’s office
5 days prior to biopsy:
To avoid the risk of increased bleeding, it would be ideal for you to avoid the medications listed below for 5 days prior to your scheduled biopsy. Put tape over the bottle top of these medications to remind you not to take them and set them aside. Tylenol (acetaminophen) is the ONLY over the counter drug for pain that you may take. You may also take pain drugs prescribed by your doctor that do not affect blood clotting. Please consult our Rosalind Benedet, RN, MSN (phone number 650-721-5419) or your prescribing physician on what pain medications would be appropriate and safe.
Medications to avoid 5 days prior to biopsy:
- Aspirin, including baby aspirin,
- Any drugs for pain or arthritis that could affect blood clotting (Examples: Advil, Aleve, Ibuprofen, Motrin, Percodan)
- Any herbal medications, including Gingko Biloba
- Fish oil or omega-3 fatty acids
For a fine needle aspiration, there is no need to avoid these medications following the procedure.
5. How do I take care of my biopsy site?
AFTER A CORE BIOPSY:
- We will place a transparent, water-tight, dressing over the biopsy site. Please keep the dressing on. Remove the dressing on the seventh day.
- You may shower the next day. Please do not soak the dressing in water until 7 days after the biopsy (i.e., bathing, swimming, hot tubs)
- We will place an ice pack in your bra. Please keep the ice pack on for an hour.
- After an hour, apply an ice pack for 10 minutes every hour, until bedtime. Do not apply the ice pack directly on your skin.
- Avoid strenuous activities for three days, such as house work, yard work or sports.
- If you have discomfort, take Tylenol only. After three days, you may go back to your regular medications.
- You may drive yourself home after the biopsy. (Only if you are not taking anti-anxiety medication.)
- Plan to relax at home after the biopsy. If you must go to work, please speak to our nurse, Rosalind Benedet, RN, MSN, at 650-721-5419, prior to your biopsy.
AFTER YOUR FINE NEEDLE ASPIRATION:
A bandage will be placed over the site where the needle was inserted. You may remove the bandage, bathe or shower, and resume normal activity that same night.
6. How and when do I get my biopsy results?
Your pathology results should be ready in 3 working days.
- Please call your referring doctor for the pathology results
- If you cannot get in touch with your doctor, please call our nurse, Rosalind Benedet, RN, MSN, at 650-721-5419 for the pathology results
- In most cases, if your pathology results are benign (negative for breast cancer), we usually recommend that you return for follow-up imaging at 6, 12, and 24 months after biopsy. Please consult your doctor for post-biopsy follow-up instructions that are appropriate for you.
- In some cases, the tissue sample is not benign. For final recommendations, please consult your doctor for post-biopsy follow-up instructions that are appropriate for you.
7. What do I do if there is bleeding at my biopsy site or other complications?
BLEEDING PROBLEMS AND OTHER POSSIBLE COMPLICATIONS:
- It is normal to have a small amount of fresh blood at your incision site (the size of a quarter)
- However, if there is a significant amount of fresh blood you will need to apply pressure to the incision site.
- Lie down and apply firm pressure over the incision site for 10 minutes. Please use a clock to time yourself. After 10 minutes, apply an ice pack for an hour. That should stop most cases of bleeding.
- In the rare instance that you cannot stop the bleeding, call Mammography at 650-736-4383, during working hours before 4 pm. During weekends or after hours, please go to the nearest Urgent Care or the nearest Emergency Room.
- Infection is rare. The signs of infection are increasing pain, swelling and redness around the incision. If you think that you have an infection, call Mammography, at 650-736-4383, during working hours before 4pm. During weekends or after hours, please go to your doctor or nearest Urgent Care or to the Emergency Room.
- Lung collapse is very rare after a breast needle biopsy, and will usually be known while you are in the Mammography Department. However, if after leaving Stanford you develop significant shortness of breath, call 911 and go directly to the nearest Urgent Care or Emergency Room.
8. Can I go back to work after my biopsy?
AFTER YOUR FINE NEEDLE ASPIRATION:
There are no limitations to strenuous activity following a fine needle aspiration.
AFTER YOUR CORE BIOPSY:
Plan to relax after the biopsy.
We recommend avoiding strenuous activities for three days after your biopsy, such as heavy lifting, housework, yard work or sports. You will also be placing an ice-pack on your breast for 10 minutes every hour, during the day of your biopsy until bedtime.
If your work involves strenuous activities, you must go back to work following your biopsy, or you have limited access to ice-packs at work, please speak to our nurse, Rosalind Benedet, RN, MSN, at 650-721-5419, prior to your biopsy.
9. What kind of follow-up do I need after my biopsy?
Every case is different and you should consult your doctor for recommendations that are appropriate for your case.
In most cases, if your pathology results are benign (negative for breast cancer), we usually recommend that you return for follow-up imaging at 6, 12, and 24 months after biopsy.
In some cases, the tissue sample is not benign and you may need surgery or other kinds of medical work-up. For final recommendations, please consult your doctor for post-biopsy follow-up instructions that are appropriate for you.
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