Q. I’ve had a “questionable” mammogram, and I know the next step might be a biopsy. What exactly is a biopsy?
A. A biopsy is acknowledged to be the single most important tool available for diagnosing cancer. It’s simply removal of some of the lump you’ve felt in your breast, or some of the tissue identified as “questionable” in your mammogram. This tissue is then examined by a pathologist, who can determine whether or not it includes cancer cells.
Q. Are there different types of biopsy, or is it one size fits all?
A. There are different types. Some are done with very fine needles under local anesthetic, leaving no scar; some are full-scale lumpectomies, i.e., a portion of your breast is removed surgically, with a resultant scar or “divot” left behind. And there are other types of biopsy between those two extremes.
Q. So, what kind of biopsy will I be getting?
A. It depends on what your mammogram looks like, what your breast feels like to the doctor who examines you, what type your doctor or hospital prefers… there are a host of factors that determine what kind of biopsy you’ll have. If you do need a biopsy, ask the doctor to tell you what kind, and explain why he or she thinks it’s right for you. Many hospitals are moving away from surgical biopsies towards the less invasive needle biopsies; they’re an easier procedure to perform, shorter in duration, less painful, and requiring less medication; they leave your breast less scarred; and they’re less expensive. But they’re more precise, and therefore demand more skill by the doctor or radiologist performing them, and perhaps more sophisticated equipment. If your doctor recommends a surgical biopsy, ask the reason why; a needle biopsy, if at all possible, will be easier on you.
Q. OK, assuming I can have a needle biopsy, what’s it like?
A. Needle biopsies come in two types, basically: a fine needle biopsy, or a core biopsy. They both involve sticking a needle into your breast, but don’t worry! A local anesthetic takes care of any pain.