Open Surgical Biopsy (Excisional and Incisional)

How Should Patients Prepare for Open Surgical Biopsy?

Patients are typically given detailed instructions by their physician and anesthesiologist in advance of the day of their surgical biopsy. Patients should avoid eating or drinking anything after midnight if they are scheduled for a surgical biopsy the next morning or afternoon. There are exceptions when patients may be instructed to take certain regular medications, such as blood pressure medications or diabetes medication, by their physician or anesthesiologist.

Women should not wear talcum powder, deodorant, lotion, or perfume under their arms or on their breasts on the day of the biopsy (as these may cause image artifacts or other problems). Patients who take blood thinners or aspirin should ask their physician about discontinuing them prior to surgery (typically three days for coumadin or other blood thinners, seven days for aspirin or ibuprofen).

What Should Patients Expect After Open Surgical Biopsy?

Open surgical biopsy requires stitches and a longer period of recovery than percutaneous ("through the skin") breast biopsy procedures (such as fine needle aspiration (FNA), core needle biopsy, or vacuum-assisted biopsy). Usually, at least one full day of recovery is required.

The scar from a surgical biopsy is typically small. However, whether or not surgery will change the shape of a woman’s breast depends on a number of factors, including:

• The size of the breast lesion
• The location of the breast lesion
• The amount of surrounding breast tissue that is removed in addition to the lesion

What are the Advantages and Disadvantages to Open Surgical Biopsy?

Surgical biopsy yields the largest breast tissue sample of all the breast biopsy methods, and the accuracy of a diagnosis using the open surgical method is close to 100%, making it the "gold standard" of breast biopsy methods.

Nevertheless, while surgical biopsy may be the best choice for some patients, it does have disadvantages, especially if the breast lesion is found to be benign (non-cancerous):

• It requires stitches and can leave a scar
• Scar formation within the breast may persist for 12 months or longer and may complicate the interpretation of follow up mammograms

Other, more rare complications may include:

• Chances of bleeding, infection, or problems with wound healing
• Mortality risks associated with the use of anesthesia
• The chance of having a piece of the localizing wire break off deep within the breast (though this is not usually a serious problem even if it does occur)

Women are strongly encouraged to discuss all aspects of their biopsy with their surgeon prior to undergoing the procedure. Surgical biopsy usually requires at least one day of recuperation at home after surgery. Women should also discuss possible alternatives to surgical breast biopsy with their physician, such as vacuum-assisted biopsy and core needle biopsy.

Updated: August 29, 2007

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