Biopsy Basics: What to Expect and Why It Matters?

10 min read

If you've been told you need a breast biopsy, feeling nervous is completely natural. The word "biopsy" can sound intimidating, but understanding what to expect can ease your anxiety. A biopsy is simply a way for doctors to get a closer look at an area of concern in your breast tissue. It's the only definitive way to determine whether a suspicious area is cancerous or benign. According to MD Anderson Cancer Center, 75-80% of breast biopsies don't result in a cancer diagnosis, but they're a crucial step in making sure you get the right care.

What Is a Breast Biopsy?

A breast biopsy is a procedure where a small sample of breast tissue is removed and examined under a microscope by a pathologist—a doctor who specializes in analyzing tissue. This helps determine whether cells are cancerous, pre-cancerous, or non-cancerous (benign).

The Mayo Clinic highlights here the different types of breast biopsies that exist—the one recommended for you will depend on factors like the size, location, and characteristics of the area in question. Most breast biopsies are outpatient procedures, meaning you can go home the same day.

How to Prepare for a Breast Biopsy

Preparing for a breast biopsy can help ensure a smoother experience and recovery:

Avoid blood thinners: The Cleveland Clinic explains the importance of talking to your doctor if you take aspirin, ibuprofen, or any blood-thinning medications. They may request that you pause them before your procedure to reduce the risk of excessive bruising or bleeding.
Wear comfortable clothing: Choose a loose-fitting top that's easy to remove or adjust, as you may need to change into a gown. Additionally, having a shirt that opens in the front (button-up or zip-up) can be easier to put on after your biopsy.
Bring a supportive bra: A well-fitting, supportive bra can help reduce discomfort and keep bandages in place after the procedure—Memorial Sloan Kettering Cancer Center highlights the importance of a tight-fitting bra to put on after your biopsy.
Follow eating instructions: Most needle biopsies don't require fasting, but if you're having a surgical biopsy, you may need to avoid eating or drinking for a certain period before the procedure.
Arrange for support: While many biopsies allow you to resume normal activities quickly, having someone available to drive you home may be helpful, especially if you feel sore or lightheaded afterward.
Have ice packs ready: Ice packs can help to relieve swelling and bruising, and having a few ready in the freezer to use once you get home may help you to feel more comfortable.

Types of Breast Biopsies

Core Needle Biopsy (CNB)

This is the most common type of breast biopsy according to the American Cancer Society (ACS). A radiologist or surgeon uses a hollow needle to remove small tissue samples. It's usually performed with imaging guidance, such as ultrasound, mammography, or MRI, to ensure accuracy. A local anesthetic numbs the area, and you may feel some pressure but not pain.

Fine Needle Aspiration (FNA) Biopsy

This is the least invasive type of breast biopsy and is typically used for lumps that feel easily accessible. A very thin needle is inserted into the lump to withdraw a small sample of cells or fluid. FNA is often used to determine if a lump is a fluid-filled cyst or a solid mass. It doesn't always provide enough information for a definitive diagnosis, so additional testing may be needed.

Stereotactic Biopsy

This specialized type of core needle biopsy uses mammography (X-ray) images to guide the needle to an area that's difficult to feel but visible on imaging. The Cleveland Clinic explains that it's often used when microcalcifications—tiny calcium deposits that may indicate early changes in breast tissue—are found on a mammogram. During the procedure, you'll lie face down on a special table with an opening for your breast, or you may be seated while the breast is compressed, similar to a mammogram.

Ultrasound-Guided Biopsy

This type of biopsy is used when an abnormality is visible on ultrasound but not as easily seen with other imaging techniques. While you lie on your back, a doctor will use ultrasound to locate the suspicious area and guide a core needle to take tissue samples. Like other needle biopsies, local anesthesia keeps you comfortable.

MRI-Guided Biopsy

This method is used when an abnormality is best seen on an MRI scan. While you lie face down in an MRI machine, contrast dye is injected into your bloodstream to enhance the images. A doctor then uses MRI guidance to pinpoint the area of concern and take tissue samples using a core needle. UCSF Health underscores the value of this technique, especially for finding some abnormalities that don't appear on mammograms or ultrasounds.

Surgical (Excisional) Biopsy

In some cases, if a needle biopsy is inconclusive or if the area of concern needs to be removed entirely, a surgeon may perform a surgical biopsy. This procedure is done in an operating room, typically under local or general anesthesia. The surgeon removes part or all of the suspicious area, and stitches may be needed to close the incision.

What to Expect After a Biopsy

Most breast biopsies are quick procedures with minimal recovery time. You may have some bruising, swelling, or tenderness in the area, but these symptoms usually resolve within a few days. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort. If you had a core needle or surgical biopsy, your doctor might place a small marker inside your breast at the biopsy site to help track the area for future imaging.

Your biopsy sample is sent to a lab, where a pathologist examines the cells and prepares a report. Results usually take a few days to a week, though some cases may take longer. Waiting for results can be one of the hardest parts of the process, but remember that having a biopsy doesn't necessarily mean you have cancer.

📖 Read more about waiting for results and coping with the uncertainty.

Understanding Your Results

Your pathology report will indicate whether the tissue is:

Benign (non-cancerous): Many breast changes, like fibroadenomas and cysts, are harmless and require no further treatment.
Atypical (abnormal, but not cancerous): Some conditions—such as atypical ductal hyperplasia (ADH), which according to the NIH is relatively common and can be found in about 5%-20% of breast biopsies—may increase the risk of breast cancer and require monitoring or additional testing.
Malignant (cancerous): If cancer is detected, you may require additional imaging, surgery, or other treatments.

Moving Forward

If your biopsy results show no signs of cancer, you may simply return to routine breast screenings. If further evaluation is needed, a doctor will guide you through the next steps, whether that means monitoring an abnormal finding or beginning treatment. No matter the outcome, you're not alone—there are many resources and support systems available to help you through the process.

Understanding what happens during a breast biopsy can make the experience less daunting. If you have concerns or questions, don't hesitate to reach out to your Defiant Health team. Your health and peace of mind matter, and taking this step is an important part of getting the answers you need.