Physical exam and images from mammogram or ultrasound are only part of breast cancer detection. If abnormal findings result from these tests, a biopsy (tissue sample) will be necessary to make a definitive diagnosis.

Core Biopsy

The procedure used to collect tissue is called a core biopsy. It is often performed in a breast surgeon’s office or breast center. Medication is used to numb the breast; then a hollow needle or core biopsy device, often with ultrasound, mammogram, or breast MRI guidance, is used to obtain samples of breast tissue. The incision is smaller than a fingernail width and can be closed using butterfly adhesive bandages (Steri-Strips), surgical glue, or a single suture. The pathologist is almost always able to determine whether or not cancer is present by analyzing these core samples.

Because many of the abnormalities found on exam, mammogram, and ultrasound are not cancer, minimally invasive breast biopsy using a core biopsy device keeps many patients who have benign (noncancerous) breast abnormalities out of the operating room, while providing peace of mind that the abnormality is not cancer. For the patient who does have cancer, it eliminates a trip to the operating room for diagnosing breast cancer. Furthermore, core biopsy sampling does not cause major alteration to the breast tissue, such as those that may occur with a surgical biopsy where an entire lump or abnormality is removed. Core biopsies also do not limit a patient’s choices in how to treat their breast cancer as may happen when a patient has their cancer diagnosed with a surgical biopsy. Finally, in this day of cost containment, a minimally invasive breast biopsy is much less expensive than an open surgical biopsy for patients.

Surgical Biopsy

Unfortunately, not all lesions can be sampled by using a core biopsy device. Some breast abnormalities require a surgical biopsy to make a diagnosis. Such lesions include those that involve the skin, are very close to the chest wall, and where the breast is too thin or too thick to allow a hollow core needle biopsy.

Main Points for Breast Cancer Diagnosis

• Breast tissue is required to make a diagnosis of breast cancer.
• Needle vs knife—Needle unanimously wins “patient’s choice award.”