There are two main types of breast biopsies.

The first is a needle biopsy, which involves a doctor removing tissue or cells with a needle. A core needle biopsy is the standard and preferred way to diagnose or rule out breast cancer. Another type of needle biopsy is a fine needle aspiration.

The second main type is a surgical biopsy, which involves a surgeon making an incision in the breast and removing tissue. Surgical biopsies are rarely used today. No matter what type of biopsy you have, it’s completely normal to feel anxious leading up to the procedure.

You may find it comforting to have a family member or friend with you for support.

You may also need someone to drive you to your procedure, or you may find that having someone to handle the driving is one less thing to worry about.

To get started, we’ll begin with the core needle biopsy. It can be used to check a lump you can feel, or an abnormal area that has no symptoms, and is only seen on a mammogram or other imaging test. If a lump can be felt, the biopsy may be done in your doctor’s office, a hospital or an imaging center. Before the procedure starts, your doctor will give you a small injection of local anesthetic to numb the area. Your doctor will then take a small tissue sample from your breast using a hollow needle. They may use additional images from a breast ultrasound during the procedure to guide the needle to the abnormal area. Your doctor may also place a tiny clip inside the breast to mark the location of the lump to make it easier to find if you need breast cancer surgery later.

The tissue sample is then sent to a pathologist, who will determine whether cancer is present or not.

If cancer is detected, you’ll be referred to a surgeon or oncologist to discuss the next steps in your care. If you’ll have breast cancer surgery, the doctor will remove the clip during that procedure.

If no cancer is detected, you will not need surgery, and you’ll resume care as recommended by your doctor. The clip will be left in your breast. It’s safe to leave it there and you won’t be able to feel it.

If a lump can’t be felt, the procedure is more involved and is usually done at a hospital or imaging center. This is because your doctor needs images from a breast ultrasound, breast MRI or a special type of mammography called stereotactic mammography to help guide the biopsy device precisely to the abnormal area.

Before the procedure starts, your doctor will numb the area with a local anesthetic, so you won’t feel any pain. Then they will take several images to locate the exact spot.

Your doctor will remove a small sample of tissue using a needle. In some cases, the needle is attached to a vacuum-assisted device. The procedure is quick, but you may feel pressure or pulling on your breast, which can be uncomfortable. The tissue sample will be sent to a pathologist, who will determine whether cancer is present or not.

If you have breast cancer, the small clip placed inside your breast during the biopsy will be removed when you have surgery.

If surgery isn’t needed, it’s safe to leave the clip in your breast, and you won’t be able to feel it.

Another type of needle biopsy is a fine needle aspiration. This procedure is only used to check a lump that can be felt.

It’s a quick way to sample a breast lump or lymph nodes in the underarm area, and it’s usually done in your doctor’s office in just a few minutes.

Before the procedure, your doctor may use a small amount of local anesthetic to numb the area.

Then, they’ll insert a small needle to collect a sample of cells. The sample is sent to a pathologist, who reviews it to determine whether cancer is present.

After either type of needle biopsy, it’s normal to feel sore. Resting, placing an ice pack on the biopsy area or taking a mild pain reliever may help. You may want to think about clearing your schedule on the day of your biopsy so that you have time to rest and recover. It’s also normal to feel anxious waiting for the results. While you wait, it may be helpful to stay busy, do things you enjoy, and connect with your family members and friends. You may also want to learn about possible biopsy results and next steps or prepare a list of questions for your doctor. The second main type of breast biopsy is called a surgical biopsy. It’s needed in some cases to make a breast cancer diagnosis. When it’s done, it’s usually an outpatient procedure, so most people don’t need to stay overnight in the hospital. Your surgeon will numb the area with a local anesthetic, and you’ll also receive a sedative to help you sleep. Before a surgical biopsy, a localization procedure may be done. This means a radiologist will use a mammogram or breast ultrasound image to guide a very thin wire, radioactive seed or other marker into the suspicious area of the breast. It’s usually done if the abnormal area in the breast was first detected on an imaging test and cannot be felt. The surgeon will then make an incision and remove the abnormal tissue. They may use the wire, seed or other marker to find the area. They’ll remove the whole abnormal area, along with some normal tissue around it. The marker will also be removed.

The removed breast tissue is usually X-rayed, which allows the surgeon and radiologist to match the abnormal area seen on the mammogram to the biopsy tissue. If the areas match, it means the correct tissue was removed. If they don’t match, the surgeon may take another sample to make sure the suspicious area is removed or plan another biopsy. A pathologist will examine the tissue to see if cancer is present. If cancer is found, they will also check to see if there’s enough normal tissue surrounding the tumor. Although the goal of this type of biopsy is to diagnose breast cancer, sometimes the surgeon can fully remove the cancer. In these cases, it may be the only breast surgery needed to treat the cancer. Since a surgical biopsy is more invasive, recovery may take longer and be more uncomfortable. Talk with your surgeon about ways to help your recovery after the procedure. Before having any type of biopsy, you may find it helpful to review our list of questions to ask your health care provider on komen.org. For more information about breast biopsies, visit the Diagnosis section on komen.org.