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How Many Breast Biopsies Are Cancer

What Happens After A Breast Biopsy

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After a breast biopsy, the tissue sample is sent to the lab for a pathologist to evaluate under a microscope. They will look for cancer cells, infection, and any other explanation for the cause of the abnormal area.

The results, or pathology report, can take several business days to return. Your healthcare provider will either call you with the biopsy results or have you return for an office visit to review the findings.

From there, a treatment plan can be made, which may include either a referral to an oncology team if it is cancer or a follow-up plan with more frequent screening.

Sometimes no definitive plan is needed, especially if the tissue is a calcification, cyst, or other benign finding.

Can I Sleep On My Side After Breast Biopsy

Typically, patients can safely resume their preferred sleeping style four to six weeks after surgery. Some women may discover that their sleep preferences have changed after a breast procedure. For example, some women with breast implants may find it more comfortable to sleep on their sides rather than their stomachs.

How Painful Is A Breast Biopsy

Healthcare providers usually use a local anesthetic or general anesthetic for breast biopsies, so people who undergo a biopsy experience little discomfort.

You may feel a pinch or sting when your healthcare provider injects local anesthesia, and youll likely feel some pressure during the procedure, which is normal. You may have pain or discomfort after your biopsy, especially if youve had a surgical biopsy.

What kinds of conditions can look or feel similar to breast cancer?

Its important to remember that many different things can appear suspicious on a mammogram or feel suspicious upon a physical breast exam not just cancer. Just because your healthcare provider wants you to undergo a breast biopsy doesnt necessarily mean you have cancer, but a biopsy is the only way to know for sure.

Conditions that can look or feel similar to breast cancer include:

  • Benign breast tumors: Fibroadenoma is the most common type of non-cancerous breast tumor.
  • Fibrosis: Fibrosis happens when your breast tissue thickens and feels firm in different areas. Hormone changes often cause fibrosis.
  • Cysts: Breast cysts are fluid-filled sacs that can become painful. You can usually move them around under your skin.
  • Breast calcification: Breast calcifications are small clusters of calcium deposits that form in your breast tissue.

A note from Cleveland Clinic

Last reviewed by a Cleveland Clinic medical professional on 09/23/2022.


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What Is The Next Step If A Breast Biopsy Is Positive

If the pathology report indicates breast cancer, its likely your next step will be to visit with a breast cancer specialist, such as a breast surgeon or oncologist. Your detailed pathology report will help with clinical staging of the cancer. The stage, along with breast cancer type, will help guide the next steps.

What Percentage Of Breast Biopsies Are Not Cancer


The removed cells are examined under a microscope and further tested to check for the presence of breast cancer. A biopsy is the only diagnostic procedure that can definitely determine if the suspicious area is cancerous. The good news is that 80% of women who have a breast biopsy do not have breast cancer.

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When A Breast Biopsy Is Recommended

Your breasts might undergo small changes through your life, or big changes during pregnancy. But some breast changes arent normal and might signal a problem.

Your care team may suggest several tests to find out more about your breast changes, but the only definitive way to know if those changes are due to cancer is to get a biopsy.

Abnormal breast changes might include:

  • A lump or firmness in your breast or under your arm
  • Unusual nipple discharge
  • Red, swollen or scaly skin on any area of your breast, including the nipple and the area around it

If you notice any of these changes, or anything else out of the ordinary, reach out to your doctor. They might start to take a closer look at whats causing the change by recommending a mammogram, or in some cases an ultrasound or MRI. To get more information, your care team might have to do a second mammogram. If they suspect there may be cancer or need more information, the next step may be a breast biopsy.

How Can A Needle Biopsy Miss Breast Cancer

A needle biopsy can miss breast cancer if the needle takes a sample of tissue or cells from the wrong area or if theres a problem with the sample.

Even when samples are taken from the correct area, false negative results can occur if the pathologist misinterprets the tissue or cells as benign when in fact, cancer is present.

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What Exactly Is A Breast Biopsy And What Is The Pathologist Looking For

Women usually undergo a breast biopsy to have a suspicious area of breast tissue examined. Such suspicious areas are typically discovered during a clinical breast examination or via breast imaging . During a breast biopsy, a small tissue sample from the abnormal area is removed and examined by a pathologist using a microscope to check for breast cancer.

The sample may also be sent for NGS biomarker testing to determine if cancer driving mutations are present that can be treated with precision cancer medicines.

What To Expect From A Breast Biopsy

Common Types of Breast Cancer Biopsy

All biopsies for potential breast cancer involve taking a sample of breast tissue for examination. Your doctor may take this sample through a needle or via a small surgical incision in your breast, depending on the size and area of the suspicious area.

We offer several forms of biopsies for breast cancer, including:

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Diagnostic Limitations Of Stereotactic Biopsy

The accuracy of stereotactic core biopsy in patient care depends on appropriate tissue sampling, histologic analysis, and correlation of histopathology with imaging findings. A limited number of studies have been published in which histologic findings at stereotactic core biopsy were correlated with those at surgical biopsy. These studies are listed in Table 1. Accuracy in these series is approximately 90%. In any individual practice, this percentage will be influenced by the experience of the physician performing the biopsy, the type of lesion undergoing biopsy, and the patient population. Accuracy appears to be comparable with prone table and add-on units.

In a series of 230 lesions biopsied with guidance from an add-on device, in which five cores of each lesion were obtained and results were correlated immediately with surgical biopsy findings, stereotactic core biopsy diagnosis was accurate in 98% of masses, 100% of masses with calcifications, 100% of focal asymmetries, and 86% of architectural distortions. Of those lesions seen only as calcifications, 91% were accurately diagnosed. In this series, the overall accuracy of stereotactic biopsy was 97%.

Discordance of Biopsy Results and Imaging Patterns

Diagnosing Carcinoma Coexisting With Benign Disease

Significance of LobularCarcinoma in Situ

Other Potential Problems

How Many Lymph Nodes Are Removed

Depending on the size and other characteristics of the breast cancer, you may have one to 10 or more lymph nodes removed. Here are a few things to keep in mind:

To make sure that women have the appropriate lymph node surgery, the American Society for Clinical Oncology released guidelines on sentinel lymph node biopsy for people diagnosed with early-stage breast cancer. The guidelines say sentinel lymph node biopsy SHOULD be offered under these circumstances:

  • breast cancer in which there is more than one tumor, all of which have formed separately from one another these types of breast cancers are rare
  • DCIS treated with mastectomy
  • women who have previously had breast cancer surgery or axillary lymph node surgery
  • women who have been treated before with chemotherapy or another systemic treatment

Sentinel node biopsy SHOULD NOT be offered under these circumstances:

  • the cancer is 5 cm or larger or locally advanced
  • the cancer is inflammatory breast cancer
  • DCIS treated with lumpectomy

The guidelines also say:

  • Women with negative sentinel node biopsies shouldnt have axillary node surgery.
  • Women with one or two positive sentinel nodes who plan to have lumpectomy plus radiation also dont need axillary node surgery.
  • Women who have one or more positive sentinel nodes and plan to have mastectomy with no radiation should be offered axillary node surgery.

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What Is The Term For The Time It Takes For A Tumor To Double In Size

Tumor doubling time is the period of time that it takes for the tumor to double in size. Since it would be unethical to leave a cancer untreated to see how rapidly it grew, doubling time is estimated in a number of ways. Looking at these estimates, however, doubling times have varied widely from study to study.

A Primer On Breast Biopsy Procedures

Breast Biopsy Photograph by David A Litman

When you or your doctor detect a breast lump, a breast biopsy is frequently recommended as it is the definitive test to rule out cancer. A biopsy removes part or all of the lump and the tissue sample is sent to pathology for examination. At least 70% of lumps biopsied are benign. Every breast mass must be evaluated by a physician, although most are not cancer.

There are three main types of breast biopsy:

1. Fine-Needle Aspiration As its name suggests, a thin needle is used to draw tissue from the suspicious area. This biopsy is painless. In fluid filled masses, aspiration of the fluid will cause the mass to disappear completely. Fluid-filled masses such as simple cysts are never cancer.

2. Core-Needle This is the most common type of biopsy tool because it is comfortable for the patient and a since larger sample of the lump is removed, it is more accurate than fine-needle aspiration. The procedure is performed under local anesthesia.

If you cannot feel the mass, but it was seen on imaging such as mammogram or ultrasound, the radiologist or breast surgeon may do a core biopsy under imaging guidance. Core biopsies are also done when suspicious calcifications are noted on mammogram to rule out cancer.

Note that the majority of calcifications seen on mammogram are completely benign and need not be biopsied. The procedure is quick, painless and you can resume your normal activity right away.

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How To Tell If You Have Cancer

A biopsy is often the best way to definitively say whether or not you have cancer. Other tools, such as ultrasound and magnetic resonance imaging , can tell the doctor if an area looks suspicious. But in most cases, the only way to make a definitive cancer diagnosis is to perform a biopsy and look at those suspicious cells under a microscope. Many biopsies are performed with imaging guidance, called image-guided biopsies, where tools like ultrasound or computed tomography scans are used to help locate areas of concern and obtain biopsy material.

How To Prepare For A Breast Biopsy

Before your breast biopsy, tell your doctor about any allergies you may have, especially any history of allergic reactions to anesthesia. Also tell your doctor about any medications you may be taking, including over-the-counter drugs, like aspirin or supplements.

If your doctor recommends an MRI, tell them about any electronic devices implanted in your body, like a pacemaker. Also, tell your doctor if youre pregnant or concerned you may be pregnant.

Consider wearing a bra to your appointment. You may be given a cold pack after the procedure to help with pain and inflammation. Your bra will help keep the cold pack in place.

Before the breast biopsy, your doctor will examine your breast. This could include:

  • a physical examination

During one of these tests, your doctor may place a thin needle or wire into the area of the lump so the surgeon can easily find it. Youll be given local anesthesia to numb the area around the lump.

There are several ways a surgeon can take a sample of breast tissue. These include:

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What Is A Surgical Biopsy

Surgical biopsy. Surgical biopsies involve removing part of the entire area of concern so it can be thoroughly evaluated for breast cancer. Surgical biopsies are typically reserved until after an FNA or core needle biopsy has been done and will be used if the results from the initial test werent totally clear.

What Are The Risks And Possible Complications Of A Breast Biopsy

Real Questions | Breast Cancer Biopsy

Most breast biopsies are minimally invasive, and most people recover well from them. There are some common side effects of a breast biopsy procedure, including:

  • Pain or soreness.

If youre experiencing signs of an infection, such as redness, pus and/or a fever, contact your healthcare provider as soon as possible.

Very rare complications of breast biopsy procedures include:

  • Hemopneumothorax .

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What Happens If A Breast Biopsy Is Positive

If the pathology report indicates breast cancer, its likely your next step will be to visit with a breast cancer specialist, such as a breast surgeon or oncologist. Your detailed pathology report will help with clinical staging of the cancer. The stage, along with breast cancer type, will help guide the next steps.

Pathologists Make Sure Biopsy Tissue Is Used Effectively To Determine An Accurate Diagnosis

Pathologists are the caretakers of tissue samples and must exercise good judgment with them. Samples allow us to make a correct diagnosis. But we can also use the samples to perform additional tests, such as immunostains, which can identify where a tumor started. This is really valuable in treating cancer that has spread from another part of the body, called metastasis.

Your pathologist will also make sure that biopsy samples are used to identify other factors affecting your treatment and recovery. These can include genetic changes that could guide treatment options or predict your chance of recovery. For example, in breast cancer, pathologists use the biopsy sample to identify hormone receptors such as estrogen and progesterone receptors and human epidermal growth factor receptor . As we identify more precise characteristics of cancer from the biopsy sample, we can identify a growing number of patients who may benefit from new, more effective targeted therapies.

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Can A Breast Biopsy Tell What Stage Cancer You Have

During a biopsy, a doctor removes small pieces of breast tissue from the suspicious area so they can be looked at in the lab to see if they contain cancer cells. Needing a breast biopsy doesnt necessarily mean you have cancer. Most biopsy results are not cancer, but a biopsy is the only way to find out for sure.

When Is Excisional Biopsy The Only Surgery Needed

Minimally Invasive Breast Biopsy

Although the goal of an excisional biopsy is to diagnose cancer, sometimes the surgeon can fully remove the cancer. In these cases, excisional biopsy may be the only breast surgery needed to treat the cancer.

Some people diagnosed with breast cancer may need to have lymph nodes removed in a second surgery at a later date.

Learn more about breast cancer treatment.

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What Factors Affect The Growth Of Breast Cancer Cells

A number of factors, such as age or having a history of hormone replacement therapy, can influence the growth rate of breast cancer cells. This is important when thinking about whether a breast cancer has spread to the lymph nodes or other organs, or has not spread at all. The type of breast cancer also matters because some can spread more quickly and do so with tumors that are still relatively small.

What Are Biopsies And Why Do I Need One

Biopsies are the most common way that doctors diagnose cancer. During a biopsy, a doctor takes a small piece of tissue, called a sample, from a suspected tumor or area of concern. Then, a pathologist looks at it under a microscope to make a diagnosis. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease, including cancer.

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How Is Each Type Of Biopsy Performed

Needle biopsies are simple, fast procedures that are usually performed in the outpatient setting with local anesthesia. A needle is used to remove cells or a small amount of tissue from the suspicious area. If the abnormal area cannot be felt but only seen on a mammogram or MRI, your doctor can use additional equipment to guide the needle.

Bi Rads Assessments Allow A Radiologist To Monitor Their Own Diagnostic Accuracy

Better biopsy to detect breast cancer

While BI RADS categories have no specific meanings they do provide a benchmark for the radiologist to monitor the accuracy of their own diagnoses. Generally speaking, if a radiologist feels that a mammogram corresponds to BI-RADS category 4, it probably means, in their own mind, that they think the chances of the lesion being ductal carcinoma in situ , invasive ductal carcinoma orlobular breast carcinoma are about 80%.

If it turns out to be a fibroadenoma instead , this would be considered a false positive, but still helps the radiologist fine-tune their diagnoses, it is like quality assurance.

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What Are The Risks And Costs Associated With Each Type Of Breast Biopsy

An open surgical biopsy carries the risk of infection, blood loss, and scarring, as an incision is made during the procedure that then has to be stitched closed. An open biopsy costs three to four times more on average than a needle biopsy.

Only about 15 to 20 percent of abnormalities detected by mammography turn out to be cancerous. Given that 80 to 85 percent of lesions are benign, a definitive diagnosis of cancer should be made using a needle biopsy as the first diagnostic step for all breast abnormalities. This allows for optimal preoperative workup and planning if cancer is found. It also gives a woman time to talk about various treatment options with her doctor to decide whats best for her.

The American College of Surgeons published guidelines sanctioning the minimally invasive breast biopsy as the recommended procedure for diagnosing image-detected lesions, and the American Society of Breast Surgeons issued a statement in accordance with these guidelines. It is a quality standard that is advocated and embraced by most breast cancer organizations.


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