Image-Guided Breast Biopsy

There are several types of breast biopsies, including imaging-guided biopsy and surgical biopsies. An imaging-guided breast biopsy is a minimally invasive procedure performed by a doctor who is specially trained in breast procedures.  Imaging is used to guide a needle to the area of concern to take small tissue samples, which are then sent to the lab for evaluation.

During a biopsy, you’ll be awake the whole time.  While you can expect to be at the medical site for a total of one to one-and-a-half hours, the actual biopsy takes fewer than 20 minutes. Results are usually available in three to five business days.

Radiologists in the Sutter Health network perform the following imaging-guided biopsies.

Fine-Needle Aspiration

Radiologists typically use this procedure to take fluid out of a breast lesion seen by ultrasound. You’ll lie on your back while preliminary ultrasound images are taken of the area of interest. The breast area is numbed with anesthetic and a very small needle is guided into place using ultrasound. Fluid is taken out through the needle.

While most fluid is benign, it may sometimes be sent to the laboratory for analysis. A tiny biopsy marker made of titanium (a safe metal) may be placed to mark the spot.

Ultrasound-Guided Core Biopsy

This procedure takes a tissue sample from a breast lesion best seen by ultrasound. You’ll lie on your back for the procedure. After initial ultrasound images are taken, the breast is numbed with anesthetic and a very small skin nick is made to allow the needle to enter. The doctor guides the needle into place using ultrasound. A few tissue samples are taken and sent to the laboratory for analysis.

A tiny biopsy marker made of titanium (a safe metal) will be placed to mark the spot. Afterward, you’ll receive a gentle mammogram to confirm the marker is in the correct place and the area has been sampled.

Stereotactic or Tomosynthesis-Guided Core Needle Biopsy

This procedure takes a tissue sample from a breast lesion, such as calcifications, best seen by mammogram. You’ll lie on your stomach with your breast placed through a special opening. The breast will be gently compressed, similar to a mammogram. If it’s hard for you to lie on your stomach, please let us know prior to scheduling the procedure; we have an alternative method where you can sit upright.

First, low-dose mammographic images are taken of the area of interest. The breast is numbed with anesthetic and a very small skin nick is made to allow the needle to enter. The doctor guides the biopsy needle into place using mammographic images. A few tissue samples are taken and sent to the laboratory for analysis.

A tiny biopsy marker made of titanium (a safe metal) will be placed to mark the spot. Afterward, you’ll receive a gentle mammogram to confirm the marker is in the correct place and the area has been sampled.

MRI-Guided Core Needle Biopsy

This procedure takes a tissue sample from a breast lesion best seen by MRI. You’ll lie on your stomach in a position just like during your initial MRI. Your breast will be gently compressed. An IV inserted in your arm will inject a safe contrast dye during the procedure. The table will move in and out of the MRI tube multiple times during the procedure.

Initial images are taken of the area of interest. The breast is numbed with anesthetic and a very small skin nick is made to allow the needle to enter. The doctor guides the biopsy needle into place and takes a few tissue samples for analysis.

A tiny biopsy marker made of titanium (a safe metal) will be placed to mark the spot. Afterward, you may receive a gentle mammogram to confirm the marker is in the correct place and the area has been sampled.

Complications

Although complications are rare with imaging-guided biopsies, they can happen. Some possible complications include bleeding and infection. The radiologist will review any potential problems with you prior to the procedure. Nurses and radiologists are always available to assist with any issues that may arise after you go home.