Name of the Procedure:

Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), and imaging of the biopsy specimen, percutaneous; each additional lesion, including stereotactic guidance

Summary

A breast biopsy is a procedure to remove a small sample of breast tissue for laboratory testing. During this procedure, a small marker (localization device) may be placed to mark the biopsy area, and imaging will be used to guide and confirm the accuracy of the biopsy. This particular method involves using a needle and may involve stereotactic X-ray guidance.

Purpose

A breast biopsy helps diagnose abnormalities in the breast tissue, such as lumps or unusual changes detected in mammograms or other imaging tests. The goal of this procedure is to determine whether these changes are benign (non-cancerous) or malignant (cancerous), and to guide further treatment if necessary.

Indications

• Lumps or masses felt during a physical breast exam.
• Abnormal findings from a mammogram, ultrasound, or MRI.
• Changes in the nipple or breast skin, such as dimpling or redness.
• Unexplained breast pain or discharge.

Preparation

• Patients may need to stop taking certain medications, including blood thinners, before the procedure.
• Fasting is usually not required, but follow specific instructions from your healthcare provider.
• Wear a comfortable bra and loose-fitting clothes.
• Inform the healthcare team of any allergies or medical conditions.

Procedure Description

1. Anesthesia: Local anesthesia is administered to numb the biopsy area.
2. Initial Imaging: Mammogram or ultrasound is conducted to locate the lesion.
3. Biopsy Procedure: A needle is inserted into the breast to extract tissue samples. Stereotactic guidance (X-rays from different angles) may be used for precision.
4. Localization Device: A small marker (clip or metallic pellet) may be placed in the breast to mark the biopsy site for future reference.
5. Imaging of Specimen: The extracted tissue is imaged to ensure the correct area was sampled.
6. Completion: The needle is removed, and pressure is applied to stop any bleeding. A small bandage is placed over the biopsy site.

Duration

The procedure typically takes 30 to 60 minutes.

Setting

This procedure is generally performed in a hospital radiology department, outpatient clinic, or specialized surgical center.

Personnel

• Radiologist or breast surgeon
• Radiologic technologist
• Nurses

Risks and Complications

• Common: Bruising, bleeding, or swelling at the biopsy site.
• Rare: Infection, mild discomfort, or allergic reaction to the anesthesia.
• Management: Most complications are managed with simple measures such as applying ice packs or taking antibiotics.

Benefits

• Accurate diagnosis of breast abnormalities.
• Determines the nature (benign or malignant) of the lesion.
• Guides treatment decisions and management plans.
• Benefits are typically realized soon after lab results are obtained.

Recovery

• Post-procedure care includes keeping the biopsy area clean and dry.
• Over-the-counter pain relief medication may be taken if needed.
• Most patients resume normal activities within a day or two.
• Follow-up appointments may be scheduled to discuss biopsy results.

Alternatives

• Fine-needle aspiration (less invasive but may not provide enough information).
• Surgical biopsy (more invasive but provides more tissue for analysis).
• Imaging follow-up (for unclear cases, can monitor changes over time).
• Pros and cons should be discussed with the healthcare provider based on individual cases.

Patient Experience

• Patients will feel a pinch or pressure during the anesthesia application.
• Expect minimal discomfort during the procedure due to local anesthesia.
• Some soreness or bruising may occur afterward, manageable with pain relief measures.
• Generally, patients can return to daily activities within a short time-frame with some avoiding strenuous activities for a couple of days.