Name of the Procedure:

Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance.

Summary

This procedure is a minimally invasive method for obtaining a tissue sample from the breast using a needle. It involves localizing the area of interest with the help of ultrasound guidance, placing a marker (such as a clip or metallic pellet) for future reference, and imaging the specimen after removal.

Purpose

The procedure is primarily used to diagnose abnormalities in the breast, such as lumps or suspicious areas seen on mammograms or ultrasounds. The goals are to collect a tissue sample for analysis, to help diagnose or rule out breast cancer or other conditions, and to accurately mark the location of the biopsy for possible future surgeries or treatments.

Indications

The procedure is indicated for:

• Lumps or masses found during physical exams
• Abnormalities detected on mammograms or ultrasounds
• Areas of concern noted in other breast imaging studies
• Patients who need tissue diagnosis to guide treatment planning

Preparation

• Patients may be asked to avoid eating or drinking for a few hours before the procedure.
• Discontinuation of certain medications, like blood thinners, may be advised.
• Pre-procedure imaging (e.g., mammogram or ultrasound) may be required for better localization of the lesion.

Procedure Description

1. The patient is positioned and ultrasound gel is applied to the breast.
2. Ultrasound guidance is used to locate the lesion.
3. Local anesthesia is administered to numb the area.
4. A needle is inserted into the breast to obtain tissue samples.
5. A small marker (clip or metallic pellet) is placed in the lesion site for future reference.
6. The tissue sample is extracted and imaged to ensure an adequate sample was taken.
7. The needle is withdrawn and pressure is applied to stop any bleeding.
8. A bandage is applied over the biopsy site.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The biopsy is usually performed in an outpatient clinic, hospital radiology department, or a specialized surgical center.

Personnel

• Radiologist or breast surgeon
• Ultrasound technician
• Nurse or medical assistant

Risks and Complications

• Bruising and swelling
• Infection at the biopsy site
• Bleeding
• Pain or discomfort
• Rarely, the procedure may miss the lesion or tumor, requiring further biopsy.

Benefits

• Minimally invasive with a quick recovery time
• Provides essential information for diagnosis and treatment planning
• Accurate localization helps guide future interventions

Recovery

• Patients can typically resume normal activities shortly after the procedure.
• Mild pain or discomfort can be managed with over-the-counter pain medication.
• Avoid heavy lifting or strenuous activities for a few days.
• Follow-up appointments may be scheduled to discuss biopsy results and next steps.

Alternatives

• Surgical (open) biopsy: More invasive, requiring an incision but may be necessary for larger or harder-to-reach lesions.
• Watchful waiting: Monitoring the breast abnormality over time with repeat imaging.
• Fine needle aspiration (FNA): Less invasive but may not provide as much tissue for analysis as a core biopsy.

Patient Experience

• Patients will feel pressure or minor discomfort during the needle insertion.
• Post-procedure, some bruising or tenderness is common.
• Pain relief and comfort measures, such as applying ice packs and taking pain relievers, can be used to manage symptoms.