Prof. Dr. Rahmi Çubuk

Breast Diseases

Breast Diseases

What is a Breast Biopsy ?


A breast biopsy is the procedure of taking tissue samples from the breast for pathological examination. If the biopsy is performed under the guidance of ultrasound, mammography, or MRI, it is called a guided breast biopsy. The type of imaging device used depends on the nature of the lesion. Ultrasound, mammography, and MRI help the radiologist visualize the lesion in the breast and precisely sample the tissue from it. This imaging-guided biopsy increases the accuracy of the procedure.

What are the benefits of a breast biopsy ?
A breast biopsy, performed with imaging guidance, allows for the accurate and safe sampling of even very small tissue areas. It can prevent the need for more invasive procedures, such as surgical biopsy, which may require a longer hospital stay and recovery time. The biopsy results will assist your doctor in diagnosing the condition, determining its severity, and planning treatment.

How should I prepare for the biopsy procedure ?
The biopsy procedure typically requires minimal preparation and is performed in an outpatient setting. You may be asked to fast briefly before the procedure. Inform your doctor about any medications you are taking, as adjustments to dosages or discontinuation of certain medications (especially blood thinners) may be necessary.

How is a breast biopsy performed ?
The biopsy is performed using ultrasound, mammography, or MRI imaging. First, you will be positioned appropriately, and your skin will be sterilized. Local anesthesia is injected into your skin and underlying tissues. A biopsy needle is inserted, and a small tissue sample is taken. In most cases, multiple tissue samples are collected. After the procedure, external pressure is applied with a fingertip to the biopsy site to prevent bleeding, and the entry site is covered with a small bandage. The collected tissue samples are sent to a pathology laboratory for examination. Afterward, you will be observed for a period of time, and if your condition is stable, you will be discharged.

What are the risks ?
A breast biopsy is a safe procedure with a low complication rate. Possible complications include localized bruising, short-term bleeding, infection, and inadvertent damage to surrounding tissues. Each patient and case is different, and your doctor can provide more detailed information and answer any questions you may have regarding the biopsy.

What types of breast biopsy methods are there ?
There are two main types of breast biopsies, differentiated by the type of needle used:

  1. Core Needle Biopsy (Tru-cut)
  2. Vacuum-Assisted Biopsy

Core Needle (Tru-cut) Biopsy
The core needle biopsy, also known as Tru-cut, is a technique that has been in use for about 40 years. The advantage of this method is that it causes very little pain and bleeding. It provides more reliable results compared to the fine needle technique previously used. The core needle device consists of two interlocking parts. The internal spring mechanism operates the system and allows tissue samples to be extracted from the breast.

Vacuum-Assisted Biopsy
In a vacuum-assisted biopsy, the tissue samples are drawn toward the pathology container using a vacuum machine, where they are automatically placed. This method is often used when the core needle method is not sufficient for obtaining adequate tissue, such as in cases of microcalcifications or structural abnormalities seen on mammography. Vacuum biopsies are typically used when larger samples need to be collected. However, this method takes longer and is more expensive. The vacuum needle consists of two parts: an internal sheath that rotates to cut tissue from the breast and vacuums it into a collection container, while the outer sheath encases the entire system.

Vacuum-assisted biopsies can be guided by ultrasound, mammography (with tomosynthesis), or MRI. If the lesion is visible on ultrasound, ultrasound-guided vacuum biopsy is the simplest method. For lesions visible only on MRI, MRI-guided vacuum biopsy is performed. When microcalcifications (tiny calcium deposits) suggestive of breast cancer are present, the biopsy is conducted with mammography guidance. In this case, the lesion’s location is accurately determined using the stereotactic technique, and the procedure is called stereotactic vacuum biopsy.