Biopsies

At some point, you may have a lump or change in your breast, or an abnormal finding on a mammogram. To make sure it’s not breast cancer, you’ll have follow-up tests.

In many cases, breast cancer can be ruled out with a diagnostic mammogram, breast ultrasound or breast MRI.

If breast cancer can’t be ruled out, you’ll need to have a biopsy. A biopsy removes cells or tissue from the suspicious area of the breast. The cells or tissue are studied under a microscope to see if cancer is present.

A biopsy is the only test that can diagnose and confirm breast cancer.

Learn more about follow-up after an abnormal mammogram or clinical breast exam.

Most biopsies don’t show cancer

Although a biopsy can be scary, most breast biopsies in the U.S. don’t show cancer [1].

Still, a biopsy is needed to know whether or not something is breast cancer.

If breast cancer is found, it can be treated. With standard treatment, most people with early-stage breast cancers have a good prognosis (high chance of survival).

Learn about breast cancer treatment.

Types of biopsies

The main types of biopsies are:

Needle biopsies. A doctor removes tissue or cells with a needle.
Surgical biopsies. A surgeon makes a cut (incision) in the breast and removes tissue.

A core needle biopsy (a type of needle biopsy) is the standard and preferred way to diagnose breast cancer. In rare cases, a surgical biopsy may be needed for diagnosis.

A needle biopsy uses a hollow needle to remove samples of tissue or cells from the breast.

A pathologist studies these samples under a microscope to see if they contain cancer. If they do, the pathologist will do further tests to learn about the cancer. This information helps you and your health care provider plan your treatment.

Needle biopsies can be used to study a:

Lump that can be felt (palpable mass)
Suspicious area that can only be seen on a mammogram or other imaging test (non-palpable mass)

There are 2 types of needle biopsies:

A core needle biopsy is the standard and preferred way to diagnose breast cancer. In rare cases, a surgical biopsy may be needed for diagnosis.

Learn about factors that affect prognosis and treatment.

Core needle biopsy is the standard and preferred way to diagnose breast cancer. In rare cases, a surgical biopsy may be needed for diagnosis.

Learn more about surgical biopsies.

What type of biopsy will I have? Why? How reliable are the results of this type of biopsy?
Will my lymph nodes be sampled? If so, will a sentinel node biopsy be done? If not, why not?
Who will perform the biopsy? How often does the radiologist or surgeon perform the type of biopsy I will have? Do they specialize in breast cancer?
How long will the biopsy take?
Will I be awake during the biopsy? Can it be done in your office, or will I need to go to the hospital?
If I have a needle biopsy, who will study the samples? How much experience does that person have with breast cancer? Will a cytopathologist (a pathologist who specializes in looking at individual cells) be needed?
Will hormone receptor status and HER2 status tests be done? Others?
What medications should I avoid before the biopsy, and for how long? When can I resume my usual medications?
When will I get the pathology results?
Where will the biopsy scar be?
What side effects can I expect after the biopsy? What problems should I report to you?
When will I be able to return to my normal routine?
If I’m having a surgical biopsy, will the tissue removed during my biopsy be X-rayed to make sure all of the suspicious tissue was removed?
Will my tumor be saved? Where will it be stored? For how long? How can it be accessed in the future?

Learn more about talking with your health care provider.

It may be helpful to download and print Susan G. Komen®‘s Questions to Ask Your Doctor About Breast Biopsies resource and write on it at your next doctor’s appointment. Or, you can download, type and save it on your computer, tablet or phone during a telehealth visit using an app such as Adobe. Plenty of space and a notes section are provided to jot down answers to the questions.

There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download.

Can a biopsy miss breast cancer?

Sometimes, a biopsy can miss breast cancer.

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 there’s 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 (not cancer) when in fact, cancer is present.

How can a surgical biopsy miss breast cancer?

With surgical biopsies, it’s less likely breast cancer will be missed.

However, a surgical biopsy can miss breast cancer if the wrong area of tissue is removed. To limit this problem, health care providers use:

A localization procedure using a wire, radioactive seed or other marker before the biopsy
X-rays of tissue samples after the biopsy

Getting a second opinion

Breast cancer is complex. You may want to get a second opinion before your biopsy, or after, when you have the results.

Most health plans allow you to get a second opinion if the second doctor is a member of your health plan.

Learn more about getting a second opinion.

Breast biopsies don’t cause cancer to spread

Surgical and needle biopsies don’t cause breast cancer to spread [2-4].

Exposing breast cancer to air during surgery or cutting through the cancer doesn’t cause it to spread [2-4].

Updated 11/15/21

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Biopsy