A fine needle biopsy is used when there’s a palpable lump in your breast, and it’s a straightforward procedure for the doctor to stick a needle into the lump, withdraw some cells, and send them to pathology to be squirted onto a slide and examined.
A core biopsy involves a larger needle, and x-rays or ultrasound to guide the needle to the area in question. It’s used when the “suspicious” area isn’t so straightforward. Perhaps no one can feel a lump, but your mammogram indicates that your breast has changed since the year before. Maybe there are multiple areas that need examining. Whatever the case, anything less obvious than a lump you can feel probably calls for a core biopsy.
You’ll lie on a table, either facedown with your breast hanging down through an opening (if the doctor’s using x-rays for guidance; this is called a stereotactic biopsy), or on your back (if the doc’s using a hand-held ultrasound device for guidance).
After local anesthetic is injected, the needle will be inserted into the area in question, and a small core of breast tissue cut out and suctioned through the needle to be delivered to the pathologist. For me, this wasn’t painful. It just felt “funny;” I had an image of Roto-Rooter, the needle humming as tiny blades inside cut into tissue. When the needle is withdrawn, you’ll need nothing more than a small bandage. The whole procedure lasts about 45 minutes, and you should feel fine (if a bit shaken, emotionally) afterwards. You’ll probably feel sore in that breast for a few days–just as you’d feel sore after getting a shot–but all in all it’s pretty easy.
Q. And that’s it?
A. That’s it. It’s all over but the waiting. Which, of course, is more distressing than the biopsy itself. But take heart; 80% of breast biopsies show no cancer, and hopefully you’ll be able to forget about the whole thing and go on your merry way.
