Methods of Breast Biopsy
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.
- Fine Needle Aspiration (FNA)
- Core Needle Biopsy
- Vacuum-Assisted Biopsy (Mammotome or MIBB)
- Large Core Biopsy (ABBI)
- Open Surgical Biopsy (Excisional and Incisional)
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