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Breast Core Biopsy

Minimally Invasive Breast Biopsy

What is a core biopsy?

Mammograms are the current gold standard for confirming breast health. But what happens when a mammogram is abnormal? Many times an abnormality may be seen on the mammogram but not felt by you or your healthcare provider. It may also only be seen on an ultrasound. Therefore, the next step is to biopsy the area in question. A biopsy takes a small sample of tissue from the breast and a special physician called a pathologist will then look at this tissue sample under a microscope to identify changes that are characteristic of disease, including cancer.

You may have a choice in the type of biopsy used to evaluate the area in question. One of your options includes core biopsy (minimally invasive breast biopsy) which is a procedure performed by a radiologist at St. Luke's Breast & Bone Health. There are two types of core (minimally invasive) breast biopsies: stereotactic and ultrasound guided. These biopsies do not require anesthesia or sedation; however, a local numbing medicine will be used.

How do I prepare for a core biopsy?

A nurse will attempt to call you in the days prior to your biopsy. She will ask questions regarding medical history, allergies, and medication usage. For either biopsy, wear a comfortable, two-piece outfit and eat a light meal prior to the biopsy. You may take your medications that day. If you take medications such as aspirin, warfarin (coumadin), or other medications that thin your blood, your healthcare provider or the nurse will instruct you on use. If you have any questions regarding medications, feel free to call St. Luke's Breast & Bone Health at (319) 369-7216 and ask to speak to a nurse.

Do not wear deodorant, lotions, powders, or creams under your arms or on the breast the day of your biopsy. If you forget, there are mammogram wipes to cleanse the breast and underarm before the procedure and deodorant wipes in the dressing rooms to use after the biopsy.

How do I schedule a core biopsy?

Your healthcare provider's office will schedule the procedure. An order from your healthcare provider is required prior to performing the procedure. If your healthcare provider has given you the order, make sure to bring it will you to your appointment. To schedule a core biopsy at St. Luke's Breast & Bone Health, call Centralized Scheduling at (319) 369-8129. Any previous mammogram and/or breast ultrasound exams are needed prior to doing the exam.

Where do I come for the core biopsy?

St. Luke's Breast & Bone Health is located at 202 Tenth St. SE in the PCI Medical Pavilion. Enter through East Entrance and proceed to the second floor. Please arrive about 15 minutes before your appointment. Park in the parking ramp connected by the skywalk or free valet parking is also available at the front of the building.

What can I expect during a stereotactic core biopsy?

During the procedure, you will lie on your stomach on a specifically designed exam table. An opening in the table allows access to your breast. A nurse and mammographer assist the radiologist. As you lie on the table, the imaging unit is underneath the table. The table is raised and two x-ray images of your breast tissue are taken from different angles. The area of concern in your breast will be centered in the window of a special paddle and compression will be applied (not as tight as during your mammogram). A computer uses the breast images to locate the area in question and calculates exact directions for the radiologist to place the special biopsy needle. After the area of question is located, the skin of your breast is cleansed with special hospital soap. The radiologist will inject a small amount of local anesthetic into the breast. This anesthetic (lidocaine) is similar to what is used in the dentist office. You will feel a tiny pinch similar to a pin prick and then some burning of the lidocaine. A small nick is made in the skin and a thin hollow biopsy needle is inserted through the nick. You may feel pressure in the breast but because of the numbing medicine already given, you should not feel anything sharp. Additional x-rays will be done throughout the biopsy to ensure placement. The actual biopsy only takes a few minutes even though the entire process may take about an hour. Several (6-12) samples of tissue will be taken. After the needle is removed, your nurse will hold pressure on the breast. This is to decrease any bleeding or bruising. Additional mammograms are needed after the biopsy. Small tapes called steri-strips will close the skin nick. This will be covered with a small bandage. A small ice gel pack will be applied to the site to decrease bruising and discomfort. An additional ice pack will be sent home with you. Before leaving, you will be given additional instructions for care after the biopsy.

What can I expect during an ultrasound guided core breast biopsy?

Ultrasonography uses high frequency sound waves to image internal structures of the body, including the breast. Ultrasound is an excellent way to evaluate some breast abnormalities that may have been found by you, your healthcare provider or detected on your mammogram. Sometimes it is not possible to know whether a growth in the breast is benign or cancerous, although the majority of breast biopsies, around 80%, come back negative or benign. During the biopsy, you will be positioned on your back or slightly turned to your side. A nurse and ultrasonographer will assist the radiologist during the biopsy. The ultrasound probe, or transducer, is placed over the site of the area in question. A cold, gel-like substance will be applied to your skin. This ultrasound gel helps the sound waves travel through the breast. After locating the area of concern, a local anesthetic called lidocaine which is similar to what the dental office uses, is injected into the area. The radiologist will then guide the biopsy needle to the area of concern by constantly monitoring the needle track on the monitor screen. Tissue samples are then taken using either an automatic or vacuum-assisted device. Usually four to eight samples are taken. These samples are then sent to pathology where a specialized physician will assess the tissue structure of the sample to determine whether the area in question is benign or cancerous. The biopsy takes about five to ten minutes, although an hour is scheduled for the entire process. After the needle is removed, your nurse will hold pressure on your breast to decrease any bleeding or bruising. Additional mammograms are needed after the biopsy. Small butterfly tapes (steri-strips) are applied to the skin nick and then a small bandage. A small gel ice pack is applied to decrease the chances of swelling or bruising. An additional ice pack will be sent home with you. Before leaving, you will be given instructions for care after the biopsy. Note: At the time of a stereotactic or ultrasound guided core biopsy, a tiny stainless steel or titanium marker or clip is usually placed in your breast at the biopsy site. This is done so that your doctor or surgeon can easily find the area biopsied, for future monitoring or in the event that a follow-up procedure is needed to remove more tissue.

How will I feel after the core biopsy?

With all types of breast biopsy except a surgical biopsy, you'll go home with only a small bandage and an ice pack over the biopsy site. Although you should probably take it easy for the rest of the day, you'll be able to resume your normal activities within a day. Bruising is common after core needle biopsy procedures. To ease pain and discomfort after a breast biopsy, you may take a nonaspirin pain reliever containing acetaminophen (Tylenol) and apply a cold pack as needed to reduce swelling.

When will I find out the results?

The tissue samples need to be sent to pathology where special tests and stains are done to determine whether the tissue is benign or cancerous. These tests will take about 48 hours to complete. You will get your final results from the healthcare provider who ordered the biopsy or the breast care coordinator at Breast & Bone Health as requested by your healthcare provider.