What is the breast biopsy procedure and how is it done?

Breast cancer is the most common type of cancer in women. One out of every 7-8 women is at risk of developing breast cancer in their lifetime. People whose mothers, sisters, aunts, and grandmothers have breast cancer have an even higher risk of cancer. The person with a palpable mass in the breast is first evaluated by the physician and then evaluated by breast ultrasound or mammography according to her age. If necessary, medicated breast MRI is also used. If there is no solid part in the cystic masses in the breast, they are mostly benign and do not require a biopsy.

However, when there are suspicious findings in solid masses (spot calcification foci (microcalcification) are observed in the mass, the edges of the mass are irregular or indistinct, the mass shows excessive blood on Doppler ultrasound, and there is reverberation behind the mass, which we call acoustic shadow), breast mass biopsy is the most ideal choice for the differentiation of benign and malignant tumors. A breast biopsy is mostly performed under ultrasound guidance. Microcalcification or very small-sized masses that cannot be observed on ultrasound can also be biopsied with mammography or MRI guidance. The standard biopsy method in the breast is trucut biopsy. Fine-needle aspiration biopsy is often not sufficient, and fine-needle aspiration biopsy may be preferred in some cystic lesions.

No preliminary preparation is required for the breast biopsy procedure. Since a partial biopsy (trucut biopsy) is taken, it is recommended to discontinue blood thinners such as aspirin. Blood values are checked. The procedure is mostly done under ultrasound guidance. After cleaning the breast skin, a local anesthetic is injected into the area where the needle will pass, from under the skin to the mass area. Except for anesthesia, there is no pain during the procedure and breast biopsy is not a painful procedure. A thin incision is made on the skin, as thin as the needle will enter. Under the guidance of ultrasound, a piece is obtained from different parts of the mass 2-3 times with a thick needle. The obtained materials are evaluated by the pathologist during the process and if sufficient material is obtained, the process is terminated; In centers where chairside pathology specialists are not available, the material is prepared appropriately and sent to the pathology laboratory. The skin is cleaned in a sterile manner and the area of operation is tightly closed with small gauze pads, which we call sponges. The patient is kept under observation for 20-25 minutes and then sent home without any restrictions in his daily life.

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