Biopsy
Breast Biopsy

How to prepare for imaging guided breast biopsy

A breast biopsy is the removal of breast tissue for pathology examination and is the only definitive way for your doctor to determine if an abnormality is cancerous or not. Fortunately, about 80% of breast biopsies result in a benign (non-cancerous) diagnosis.

Until recently, breast biopsy choices were limited to surgery. In some cases, this still is the only option. Unlike surgical biopsy, imaging guided needle biopsy procedures are performed by a radiologist who obtains tissue samples from the breast using a hollow needle or vacuum assisted probe guided by stereotactic (computer assisted x-ray) or ultrasound techniques. These tissue samples can then be evaluated by a pathologist to determine if the tissue is malignant (cancerous) or benign.

Imaging guided needle biopsies are highly accurate and may provide a number of advantages over surgical biopsy for you. Imaging guided needle biopsy procedures are minimally invasive, frequently eliminate the need for surgery, cause no disfigurement and leave no residual scar tissue, which can make future mammogram interpretations difficult. As these procedures are comfortably performed under a local anesthetic, patients may resume normal activities shortly afterwards. Imaging guided needle biopsies are also performed for about one third the cost of surgical biopsy.

A radiologist performing imaging guided needle biopsy procedures has specialized training and is assisted by a technologist or ultrasonographer, who also supports you throughout the procedure. The radiologist evaluates your mammographic findings and selects a technique, stereotactic or ultrasound, to optimally locate and biopsy the lesion.

If stereotactic biopsy is chosen, your procedure will take place in a suite which is equipped with a stereotactic biopsy table. You will be helped by a technologist to lie on your stomach on a special table. The table is designed for patient comfort and access to the breast from below the table. While you lie on the table, images of the breast are obtained while the breast is compressed. Once the lesion has been located, a local anesthetic Xylocaine is injected by the radiologist to numb the breast. Once the breast is numb, a small (approximately 1/4 inch) incision is made. Using computer assisted x-ray techniques, the radiologist then guides a sampling device to the lesion and extracts the tissue samples needed for later interpretation by a pathologist.

If ultrasound guided biopsy is chosen, your procedure will take place in an ultrasound suite. While you lie on a padded table, breast ultrasound images are obtained by a sonographer. Once the lesion is in view, a local anesthetic, Xylocaine, is injected by the radiologist to numb the breast. Once the breast is numb, a small (approximately 1/4 inch) incision is made. The radiologist while watching his/her progress on ultrasound, guides a sampling device to the lesion and extracts the tissue samples needed for later interpretation by a pathologist.

Imaging guided needle biopsy sites are bandaged with a steri-strip and gauze pads. Stitches are not necessary. After a breast biopsy procedure, it is recommended that you avoid strenuous activity and relax for the remainder of the day. Resume your usual activities on the following day.

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How to prepare for imaging guided breast biopsy

Patients taking aspirin or aspirin related products:

• It is advised to stop taking aspirin or aspirin related (ibuprofen) products such as, Motrin, Advil or Aleve for a least 7 days before these procedures to avoid excessive bleeding. Tylenol (acetominefin) is an acceptable substitute.

Patients taking Coumadin (anti-coagulants, blood thinners)

• Consult with physician before scheduling this procedure.
  
  
• It is generally advised to stop taking Coumadin (anti-coagulants, blood thinners) for 3 (three) to 5 (five) days prior to these procedures to avoid excessive bleeding.

Patients requesting muscle relaxant / oral sedation for procedure (see below)

• These medications, available by request at the time of the procedure, can make lying on the biopsy table more comfortable.

To avoid delay or rescheduling of your biopsy

• Arrive 15 minutes before your scheduled appointment time to register for your procedure.
  Plan for an additional 1-1/2 hours to complete your procedure.
  Please do not wear any powder, perfumes, deodorant and/or lotions on your underarms and breasts to the exam. Moist towelettes are provided and deodorant is available to reapply after your procedure.

Patients requesting muscle relaxant / oral sedation

• Arrive at the radiology reception desk 30 minutes before your scheduled appointment to register for your breast biopsy procedure and take your prescribed medication.
  
  
• Avoid use of caffeinated products on the day of the procedure.
  
  
• Make arrangements to be driven home after your procedure.
  
  
• Plan to rest for the remainder of the day. Do not drive, operate machinery or make important (legal) decisions for 24 hours following your procedure.

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