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Breast Biopsies

At some point, you may have an abnormal finding on a screening mammogram or notice a lump or change in your breast. To learn whether or not it’s breast cancer, you’ll have follow-up tests.

In many cases, breast cancer can be ruled out with additional breast imaging. This may be a diagnostic mammogram, a breast ultrasound, or a breast MRI.

If breast cancer can’t be ruled out after this additional imaging, you’ll need to have a biopsy. A biopsy removes cells or tissue from the suspicious area of the breast. A pathologist studies the cells or tissue under a microscope to see if cancer is present.

A biopsy is the only test that can diagnose and confirm breast cancer.

Learn more about follow-up after an abnormal mammogram or clinical breast exam.

Watch our video of Former Komen Chief Scientific Advisor Dr. George Sledge who explains why you may need a breast biopsy and the information the test can give you if you’re diagnosed with breast cancer.

Most biopsies don’t show cancer

Although a biopsy can be scary, most breast biopsies in the U.S. don’t show cancer [1].

Still, a biopsy is needed to know whether or not something is breast cancer.

If breast cancer is found, it can be treated. With standard treatment, most people with early-stage breast cancers have a good prognosis (high chance of survival).

Learn about breast cancer treatment.

Types of breast biopsies

The main types of breast biopsies are:

A core needle biopsy (a type of needle biopsy) is the standard and preferred way to diagnose breast cancer. In rare cases, a surgical biopsy may be needed for diagnosis.

A needle biopsy uses a hollow needle to remove samples of tissue or cells from the breast.

A pathologist studies these samples under a microscope to see if they contain cancer. If they do, the pathologist will do further tests to learn about the cancer. This information helps you and your health care provider plan your treatment.

Needle biopsies can be used to study a:

  • Lump that can be felt (palpable mass)
  • Suspicious area that can only be seen on a mammogram or other imaging test (non-palpable abnormal finding)

There are 2 types of needle biopsies:

A core needle biopsy is the standard and preferred way to diagnose breast cancer. In rare cases, a surgical biopsy may be needed for diagnosis.

Learn about factors that affect prognosis and treatment.

Core needle biopsy is the standard and preferred way to diagnose breast cancer. In rare cases, a surgical biopsy may be needed for diagnosis.

Learn more about surgical biopsies.

  • What type of breast biopsy will I have? Why this type? How reliable are the results of this type of biopsy?
  • Will my lymph nodes be sampled? If not, why not?
  • Who will perform the biopsy? How often does the radiologist or surgeon perform the type of biopsy I will have? Do they specialize in breast cancer?
  • How long will the biopsy take?
  • Will I be awake during the biopsy? Can it be done in your office, or will I need to go to the hospital or an imaging center?
  • Will I need someone to drive me home?
  • If I have a needle biopsy, who will study the samples? How much experience does that person have with breast cancer? Will a cytopathologist (a pathologist who specializes in looking at individual cells) be needed?
  • Will hormone receptor status and HER2 status tests be done? Others?
  • What medications should I avoid before the biopsy, and for how long? When can I resume my usual medications?
  • How will I get the results of the biopsy? When will I get the pathology report?
  • Where will the biopsy scar be?
  • What side effects can I expect after the biopsy? What problems should I report to you?
  • When will I be able to return to my normal routine?
  • If I’m having a surgical biopsy, will the tissue removed during my biopsy be X-rayed to make sure all of the suspicious tissue was removed?
  • Will my tumor be stored? Where will it be stored? For how long? How can it be accessed in the future?

Find a list of questions you may want to your health care provider after your breast biopsy.

Learn more about talking with your health care provider.

It may be helpful to download and print Susan G. Komen®‘s Questions to Ask Your Doctor About Breast Biopsies resource and write on it at your next doctor’s appointment. Or you can download, type and save it on your computer, tablet or phone using an app such as Adobe. Plenty of space and a notes section are provided to jot down answers to the questions.

There are other Questions to Ask Your Doctor resources on many different breast cancer topics you may wish to download.

Can a biopsy miss breast cancer?

Although it’s rare, a biopsy can miss breast cancer.

How can a needle biopsy miss breast cancer?

A needle biopsy can miss breast cancer if the needle takes a sample of tissue or cells from the wrong area. To limit this problem with core needle biopsies, health care providers use imaging to guide the biopsy. This involves a localization procedure using a wire, radioactive seed or other marker before the biopsy.

Even when samples are taken from the correct area, false negative results can occur if the pathologist misinterprets the tissue or cells as benign (not cancer) when in fact, cancer is present. This is very rare.

A needle biopsy can also miss breast cancer if there’s a problem with the quality of the sample or the pathologist can’t do the necessary tests or can’t interpret the results.

How can a surgical biopsy miss breast cancer?

With surgical biopsies, it’s less likely breast cancer will be missed.

However, a surgical biopsy can miss breast cancer if the wrong area of tissue is removed. To limit this problem, health care providers use:

Getting a second opinion

Breast cancer is complex. You may want to get a second opinion before your biopsy, or after, when you have the results.

Most health plans allow you to get a second opinion if the second doctor is in your health plan’s network.

Learn more about getting a second opinion.

Breast biopsies don’t cause cancer to spread

Surgical and needle biopsies don’t cause breast cancer to spread [2-4]. Exposing breast cancer to air during surgery or cutting through the cancer doesn’t cause it to spread [2-4].

Updated 12/20/22

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Breast Biopsy