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Methods of Breast Biopsy

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Image courtesy of Siemens Medical.

Several methods of breast biopsy now exist. The most appropriate method of biopsy for a patient depends upon a variety of factors, including the size, location, appearance and characteristics of the breast abnormality. Click on one of the biopsy methods below for a detailed explanation of the procedure.

Biopsy Methods:

Summary and Illustrations of Biopsy Methods

Summary of Breast Biopsy Methods

Type Used For Needle Sample size Anesthesia Pros Cons
Fine Needle Aspiration (FNA) Cysts; sometimes also used to sample cells from masses with or without calcifications 22 or 25 gauge needle; several (5-6) samples of fluids and/or cells are removed Local or none Fastest and easiest method; results rapidly available; no stitches or scar; excellent for cysts Small sample size may cause incomplete assessment or misdiagnosis; multiple needle insertions; operator dependent
Core Needle Sample tissue from solid mass or calcium deposits 10, 11, or 14 gauge needle; several (5-6) samples are removed Local Larger sample than FNA can lead to more accurate diagnosis; no stitches or internal scar Multiple needle insertions; limited sample size may underestimate more serious diagnosis
Vacuum-Assisted (Mammotome or MIBB) Primarily used for calcifications 11 or 14 gauge needle. Requires 0.25 inch incision (approx. 0.6 cm); several (8-10) samples are removed Local Excellent for calcium deposits; removes several large samples with one needle insertion; no stitches; minimal scar May be less accurate than surgical biopsy which removes entire lesion; not ideal for hard-to-reach lesions (i.e., near chest wall); operator dependent
Large Core Surgical (ABBI) Primarily used for nonpalpable (unable to feel) masses and/or calcifications 5mm-20mm to cylinder of breast tissue is removed (approx. size and shape of wine cork) Local Provides large sample without heavy sedation (as with surgical biopsy) Removes large amount of normal tissue before reaching lesion, may not remove adequate margin of tissue around lesion; requires stitches; scar
Open Surgical Masses, hard-to-reach lesions, (i.e. near chest wall) multiple lesions; masses with micro-calcifications Requires 1.5 to 2 inch incision (approx. 4.0 to 5.0 cm); golf ball size area of tissue or more is removed Heavy sedation; sometimes general anesthesia Yields largest tissue sample; most accurate method of diagnosis (near 100%) Causes permanent scar that may make future mammograms difficult to read; possible breast disfigurement; requires stitches and longer recovery

Updated: May 4, 2008