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Breast Cancer: Needle Biopsy

Needle biopsies are procedures to remove breast tissue or fluid with a needle for examination under a microscope. These procedures are commonly used to diagnose breast cancer.

There are two main types of needle biopsies:

  • Fine needle aspiration biopsy
  • Core biopsy

Fine Needle Aspiration Biopsy

In fine needle aspiration biopsy, the doctor uses a very thin needle attached to a syringe to withdraw a small amount of tissue from the suspicious area. If the area to be biopsied can be felt, the doctor locates the lump or suspicious area and guides the needle there. If the lump can’t be felt, the doctor might use ultrasound to watch the needle on a screen as it moves into the mass.

Once the needle is in place, fluid or tissue is drawn out. If clear fluid is withdrawn, the lump is more likely a benign cyst (not cancer). Bloody or cloudy fluid can mean either a benign cyst or, less often, cancer. If the lump is solid, small pieces of tissue are drawn out and a pathologist will look at the biopsy tissue or fluid under a microscope to find out if it’s cancer.

Core Needle Biopsy

A core needle biopsy is much like a fine needle aspiration biopsy. A slightly larger, hollow needle is used to withdraw small cylinders, or cores, of tissue from the abnormal area in the breast. The needle is put in three to six times to get the samples. This takes longer than a fine needle aspiration biopsy, but it’s more likely to give a clear result because more tissue is taken to be checked.

The doctor doing the core needle biopsy usually places the needle in the abnormal area using image guidance to be sure it’s in the right place.

What to Expect

During a fine needle aspiration biopsy, the doctor may use a local anesthetic, but the needle used for the biopsy is so thin that getting the medicine may hurt more than the biopsy itself.

A core needle biopsy is most often done in the doctor’s office with local anesthesia (you are awake but your breast is numbed). The procedure can cause some bruising but usually does not leave scars inside or outside the breast.