Whenever there is a suspicious abnormality in the breast, a biopsy is necessary. Biopsies can be performed surgically or with a needle, but in most instances, needle biopsy is preferable to surgery for diagnosis. If the needle biopsy results are benign, surgery can usually be avoided. If the results are malignant, the lymph nodes can be sampled at the same time as the lumpectomy, thereby eliminating the need for two separate surgeries.
Needle biopsies can be performed in two ways, depending on which tests show the abnormality. If the abnormality can be seen with ultrasound, we generally do an ultrasound-guided biopsy, making certain that the needle can be seen inside the nodule throughout the biopsy. In our practice, these biopsies are usually done on the same day as the ultrasound test. This helps to minimize the period of uncertainty and anxiety for our patients.
If the abnormality is visible only on mammography (usually suspicious calcium deposits), a stereotactic biopsy is performed. In this procedure, a mammogram machine takes angled pictures of the abnormal area and a computer calculates where the needle should be positioned for the biopsy. Several biopsy samples are then taken with a specialized biopsy needle.
MRI-guided breast biopsy, magnetic resonance imaging is used to help guide the radiologist's instruments to the site of the abnormal growth, which can only be identified with the MRI machine.