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Surgical Breast Biopsy: Types of Biopsies

A surgical breast biopsy requires a cut (incision) in your skin. This allows your healthcare provider to take a large piece of tissue from the breast. In fact, sometimes the whole lump is removed. When this is done, it's called an excisional biopsy. In some cases, only a piece of a large tumor may be taken out. This is called an incisional biopsy. The tissue that's removed is sent to a lab for testing.

Most women don't need a surgical biopsy. Changed breast tissue can often be removed with a needle and sent for testing. A biopsy is the only way to know for sure that a change in your breast is breast cancer.

Open surgical biopsy

Open surgical biopsy removes a tissue sample through a small cut in the skin over the lump.

To keep you from feeling pain during the biopsy, you may be given IV (intravenous) sedation and local anesthesia. This means drugs are used to make you sleepy and to numb your breast so you don't feel the surgery. Another option is general anesthesia. In this case, drugs are used to put you into a deep sleep so you don't feel pain.

Your surgeon then makes an incision (cut) in the skin over your breast. If possible, this is done in a way that hides the scar. In most cases, all of the lump is removed along with a margin (edge) of healthy tissue around it. The incision is then closed with stitches. Some stitches dissolve on their own. Others may need to be removed when the incision heals.

Side view of female breast with ducts and lobules ghosted in. Dotted line over lump shows incision for surgical biopsy.

Wire localization

A lump that can’t be felt may be hard to find during surgery. In such a case, a mammogram or ultrasound can be used to find the lump before the biopsy. The images are used to guide a thin needle into the area. A thin wire with a tiny hook on the end is put in through the needle. The hooked end is in the area to be removed.

You are then taken to the operating room for surgery. The wire guides the surgeon to the tissue that's removed during the biopsy. It's removed along with the tumor or changed breast tissue.

Side view of female breast with ducts and lobules ghosted in showing wire going through skin into lump.

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