Open (Surgical) Biopsy

Most doctors will first try to figure out the cause of a breast change by doing a needle biopsy, but a surgical biopsy may be recommended in some cases. A surgical biopsy is done by cutting the breast to take out all or part of the lump so it can be looked at under the microscope. This may also be called an open biopsy. 

There are two types of open (surgical) biopsy:

  • An incisional biopsy removes only part of the suspicious area, enough to make a diagnosis.
  • An excisional biopsy removes the entire mass or abnormal area, with or without trying to take out an edge of normal breast tissue (it depends on the reason for the excisional biopsy).

In rare cases, a surgical biopsy can be done in the doctor’s office, but it’s more often as an outpatient procedure in the hospital under local anesthesia (you are awake, but your breast is numb).

A surgical biopsy is more involved than a fine needle aspiration or a core needle biopsy. Stitches are often needed and it will leave a scar. The more tissue removed, the more likely it is that you will notice a change in the shape of your breast. Your doctor will tell you how to care for the biopsy site and what you can and can’t do while it heals.

What to Expect

Surgical biopsies are usually done in an office or a clinic on an outpatient basis, meaning you will go home the same day as the procedure. Local anesthesia is used for some biopsies to prevent you from feeling any pain in your breast during the procedure.