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; each additional lesion, including ultrasound guidance

Summary

A percutaneous breast biopsy involves removing a small sample of breast tissue for laboratory analysis. This procedure is sometimes combined with the placement of a localization device, such as a clip or metallic pellet, to mark the biopsy site. Ultrasound guidance is used for precision, especially when targeting additional lesions.

Purpose

This procedure is primarily used to diagnose breast abnormalities, such as lumps or suspicious areas detected on mammograms. It aims to determine if these abnormalities are benign (non-cancerous) or malignant (cancerous).

Indications

• Suspicious breast lumps or masses
• Abnormal areas found during mammography or ultrasound
• Changes in breast tissue noticed during physical exams
• Pre-existing breast conditions that require monitoring

Preparation

• Follow fasting instructions if sedation is planned
• Adjust medications as advised by your healthcare provider
• Complete any required diagnostic tests, such as mammography or ultrasound, beforehand

Procedure Description

1. Anesthesia: Local anesthesia is administered to numb the breast area.
2. Imaging: Ultrasound is used to locate the lesion accurately.
3. Biopsy: A small incision is made, and a biopsy needle is inserted to extract tissue samples.
4. Localization Device: If needed, a clip or metallic pellet is placed in the breast to mark the biopsy site for future reference.
5. Specimen Imaging: The biopsy specimen may be imaged to ensure accurate sampling.
6. Additional Lesions: The process is repeated for any additional suspicious lesions.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in an outpatient setting, such as a hospital, clinic, or surgical center.

Personnel

• Radiologist or breast surgeon
• Radiologic technologist
• Nurse for patient assistance and monitoring

Risks and Complications

• Bleeding or bruising at the biopsy site
• Infection
• Pain or discomfort during and after the procedure
• Rarely, changes in breast shape or contour

Benefits

• Provides a definitive diagnosis for breast abnormalities
• Guides treatment decisions
• Minimally invasive with quick recovery time

Recovery

• Follow post-procedure care instructions, such as applying ice packs and keeping the biopsy site clean
• Over-the-counter pain relief may be recommended
• Avoid strenuous activities for a few days
• Schedule any follow-up appointments as advised

Alternatives

• Clinical breast exam (CBE)
• Imaging tests alone (e.g., mammography, ultrasound, MRI)
• Surgical (excisional) biopsy
  • Pros and cons: Surgical biopsy is more invasive and requires longer recovery but may be necessary for larger or harder-to-reach lesions.

Patient Experience

• During the procedure: You may feel pressure or slight discomfort, but pain is usually minimal due to local anesthesia.
• After the procedure: Mild pain or tenderness can be managed with pain relievers. Most patients can resume normal activities within a day or two.