A breast biopsy is a common diagnostic procedure to investigate suspicious areas within breast tissue, such as a lump or an abnormality detected on an imaging scan. It involves removing a small tissue sample from the breast for microscopic examination. Most breast biopsies do not require general anesthesia; patients remain awake and alert throughout the process.
Anesthesia Used for Breast Biopsies
Most breast biopsies use local anesthesia, which numbs only the specific area of the breast. This is administered via an injection directly into the breast tissue, similar to how a dentist might numb a tooth. Patients may feel a brief sting, burning sensation, or pressure as the numbing medication is injected, but this quickly subsides as the area becomes numb. Local anesthesia ensures comfort and prevents pain during tissue sample collection.
Patients remain fully conscious during a biopsy under local anesthesia, allowing them to communicate with the medical team if needed. This approach also allows for quicker recovery and avoids risks and side effects associated with general anesthesia, such as nausea or prolonged grogginess.
General anesthesia, which renders a patient completely unconscious, is rarely used for breast biopsies. It may be considered for patients with extreme anxiety, complex surgical biopsies that require more extensive tissue removal, or when specific underlying health conditions necessitate it.
What to Expect During the Biopsy Procedure
Once the local anesthetic has taken effect and the breast area is numb, the biopsy procedure begins. The patient is typically positioned comfortably, often lying on their back or side, depending on the abnormality’s location. Imaging guidance, such as ultrasound, mammography (often called stereotactic biopsy), or MRI, is used to precisely locate the target area within the breast, ensuring the tissue sample is taken from the correct suspicious spot.
A very small incision, often just a few millimeters, or a puncture is made in the skin through which the biopsy needle is inserted. The most common types of biopsies are core needle biopsy and vacuum-assisted biopsy. A core needle biopsy uses a hollow needle to extract several small, cylindrical tissue samples. A vacuum-assisted biopsy uses a specialized device that uses suction to collect multiple tissue samples through a single, tiny incision, often without needing to reinsert the needle multiple times.
During the procedure, patients typically report feeling pressure, pushing, or pulling sensations, but generally no sharp pain due to the local anesthetic. Some might also hear a muffled clicking sound from the biopsy device. A tiny metallic marker clip, often smaller than a grain of rice, may be placed at the biopsy site after samples are collected; this helps mark the exact location for future reference. The entire procedure usually takes between 15 to 60 minutes, depending on the type of biopsy and its complexity.
After Your Breast Biopsy
Immediately following the breast biopsy, pressure is applied to the biopsy site to minimize bleeding and reduce the risk of bruising. A sterile dressing is then placed over the small incision or puncture. It is common to experience some side effects in the days following the procedure, including bruising, swelling, and mild discomfort or tenderness at the biopsy site. The extent of bruising can vary widely among individuals, often appearing as a dark discoloration that can spread slightly.
To manage these common side effects, healthcare providers often recommend applying an ice pack intermittently to the area for the first 24 to 48 hours to reduce swelling and bruising. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also be used to alleviate any mild discomfort, as advised by your healthcare provider. Wearing a supportive bra for a day or two can also provide additional comfort and support to the area.
It is important to monitor the biopsy site for any signs of complications. Contact your healthcare provider if you experience excessive bleeding that saturates dressings quickly, signs of infection such as increased redness, warmth, pus discharge, or fever, or if you have severe or worsening pain not relieved by medication. The tissue samples collected during the biopsy are sent to a pathology laboratory for analysis, and results are typically available within a few days to about a week. Your healthcare provider will then discuss the findings with you, often during a follow-up appointment, and outline any necessary next steps based on the biopsy results.