October 27, 2021Breast health

Biopsy: for a definitive diagnosis

Mammography and ultrasound are tests that provide images of the interior of the breast to check for abnormalities. The images provide clues about breast health, but they do not give any certainty about the nature of the abnormality detected. At this stage, if there is any doubt, the doctor will ask for a biopsy.

The breast biopsy, more detailed, involves the removal from the breast(s) of cells or tissue which are then analyzed in a laboratory. It is the only examination that can confirm whether or not there are cancerous cells present.

Why a biopsy?

The doctor will recommend a biopsy if the mammogram and breast ultrasound images show abnormalities that are suspicious or suggestive of cancer. However, a biopsy does not mean you have cancer! It is used to determine whether there are cancerous cells, and the only way to find out is to analyze a tumour sample. Remember that a tumour can be malignant, but it can also be benign!

How do I prepare for a biopsy?

There is no special preparation for a biopsy, other than wearing a top that gives easy access to the upper body and avoiding wearing bulky jewelry. It is also advisable to inform your doctor in advance if you are taking any treatment or medication that involves anticoagulants.

How is a biopsy performed?

There are different kinds of biopsy, but in general, it takes about 30 minutes. The radiologist may use small-bore needles (3 to 5 mm in diameter) for a microbiopsy, or large-bore needles (5 to 10 mm in diameter) for a macrobiopsy. In some cases, the radiologist may also use a mammogram (stereotactic biopsy) or ultrasound (ultrasound-guided biopsy).

  • • Depending on the guidance technique used, the medical team will identify the area to be analyzed and then disinfect the skin before administering a local anesthetic.
  • The radiologist will then make a small incision of 4 to 5 millimetres in the skin.
  • The doctor will then guide the needle to the tumour. Once the needle is in position, the doctor will take the required samples. At this stage, some machines make a sharp clicking sound. This procedure is not painful, as the woman is under local anesthetic, but the noise can sometimes be startling.
  • A bandage will be applied after the examination.
  • In some cases, the medical team may place what is known as a marker clip to find the exact location of the abnormality. This is a curved wire that sticks out slightly from the skin, identifying the location of the sample.
  • Once the biopsy is complete, the samples will be sent to a laboratory for analysis.

A biopsy causes more discomfort and side effects than other diagnostic tests. Within a few days of the examination, you may have a bruise at the test area, accompanied by tenderness or mild pain. No worries! There is no need to worry about this.

How is the anouncement of the results?

The results are available about three to four weeks after the examination. The doctor will ask to meet with you to show them to you and it is then that you will know if what you have is benign or malignant.

A word of advice: don’t go to this meeting alone! Even if the diagnosis turns out not to be breast cancer, you may be experiencing a lot of emotions after the whole process you have just gone through and the accompanying stress.

On the other hand, if the diagnosis turns out to be breast cancer, you may be given a lot of information: stage, grade, molecular receptor, and so on. The doctor may recommend further tests to find out more about the type of cancer you are facing and what treatment is most appropriate. This is why it is best to be with someone you trust who can take notes for you and support you during this difficult time.

You have learned with us about the process of diagnosing breast cancer, from the first worrying symptom through the mammogram, the ultrasound and finally the biopsy. Throughout this process, it is important to remember that 90% of breast symptoms turn out to be benign and only 10% are cancerous. Nevertheless, a cancer detected early is more likely to be treated easily, and with less aggressive treatments. When in doubt, prevention is better than cure!

If you have any questions or concerns about breast cancer, we are here for you, before, during and after diagnosis. Call our confidential helpline: 1 855 561-PINK.


We would like to thank OTIMROEPMQ for helping to write this article.

Bibliography

CHU de Québec-Université Laval. (2021) “Biopsie du sein micro-biopsie ou macro-biopsie guidée par échographie” (Ultrasound-guided breast microbiopsy or macrobiopsy). Viewed October 20, 2021, https://www.chudequebec.ca/patient/maladies,-soins-et-services/traitements-et-examens/examens/biopsie-a-l-aiguille-du-sein.aspx (in French).

Quebec Breast Cancer Foundation. “Breast cancer diagnosis.” Ruban rose (blog). Viewed October 14, 2021. https://rubanrose.org/en/inform-me/screening-and-diagnosis/breast-cancer-diagnosis /.

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