Name of the Procedure:

Biopsy of breast; open, incisional

• Common names: Open breast biopsy, Surgical breast biopsy
• Medical terms: Excisional biopsy

Summary

An open, incisional breast biopsy is a surgical procedure where a surgeon makes an incision in the breast to remove a sample of breast tissue for examination. This helps in diagnosing abnormalities, such as lumps, by analyzing the tissue under a microscope.

Purpose

• Medical condition addressed: Detection and diagnosis of breast abnormalities, such as lumps or areas of concern found on mammograms or through physical exams.
• Goals/Outcomes: To obtain a clear and accurate diagnosis of breast tissue to determine whether it is benign or malignant (cancerous).

Indications

• A palpable breast lump that cannot be adequately assessed through needle biopsy.
• Suspicious findings on mammograms or ultrasounds that require further investigation.
• Previous inconclusive needle biopsy results needing more tissue for diagnosis.

Preparation

• Pre-procedure instructions: Patients may need to fast for several hours before the procedure.
• Medication adjustments: Inform the surgeon about any medications being taken, particularly blood thinners, which may need to be paused.
• Diagnostic tests: A recent mammogram, ultrasound, or MRI may be required.

Procedure Description

1. Anesthesia: The patient is given local anesthesia with sedation or general anesthesia.
2. Incision: A small cut is made in the skin over the area of concern.
3. Tissue removal: A portion of the suspicious tissue is carefully excised.

4. Closure: The incision is stitched up, and a dressing is applied.

   Tools:

   • Scalpel
   • Surgical instruments for tissue handling and incision management

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is performed in a hospital, outpatient clinic, or a surgical center.

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Common risks: Bruising, swelling, discomfort at the incision site
• Rare complications: Infection, excessive bleeding, reaction to anesthesia

Benefits

• Expected benefits: Accurate diagnosis of breast tissue abnormalities.
• Timeline: Pathology results are usually available within a few days to a week.

Recovery

• Post-procedure care: Keep the incision site clean and dry, follow the surgeon’s wound care instructions.
• Recovery time: Most patients can return to normal activities within a few days, but should avoid heavy lifting or strenuous activity for about a week.
• Follow-up: Typically includes a follow-up appointment to discuss pathology results and any further treatment if necessary.

Alternatives

• Other options: Needle biopsy (fine needle aspiration or core needle biopsy), Imaging studies (mammography, MRI)
• Pros and cons: Needle biopsies are less invasive with quicker recovery but sometimes provide insufficient tissue for diagnosis, whereas open biopsy is more invasive but offers a more comprehensive tissue sample.

Patient Experience

• During the procedure: Depending on the anesthesia, the patient might be awake but sedated or fully asleep and should not feel pain during the procedure.
• After the procedure: Expect some soreness and tenderness at the incision site. Pain can be managed with over-the-counter pain relievers or medication prescribed by the surgeon. Comfort measures include applying ice packs and wearing a supportive bra.