Historically, when a woman presented with an abnormal mammogram, she was sent to a surgeon for a surgical biopsy. The woman would be taken to the operating room, given anesthesia, and the mass would be removed. In women who have fibrocystic breast disease, they may have multiple biopsies over time and the scars to go along with each procedure.

If the woman had micro-calcifications seen on the mammogram, this would require a needle placed within the calcifications and then a trip to the operating room to have everything removed. For a patient with cancer, it would require a second trip to the operating room for her partial or full mastectomy.

Today, we try to limit the number of trips to the operating room and the risk of anesthesia by performing minimally invasive breast biopsies.

There are many types of minimally invasive biopsies that use a needle. A core needle biopsy is the method of choice. It can also be used with vacuum assistance. A needle with an opening is inserted into the mass (or microcalfications) and a piece of the mass is removed. With vacuum assistance, the mass is drawn into the needle and a portion is cut. In many instances, the entire mass can be removed. A fine needle aspiration is used with a fluid filled cyst.

For an ultrasound-guided biopsy, you lay on your back with your arm placed above your head. An ultrasound will be performed in order to confirm the location of the mass. The area will be numbed with local anesthesia, a small cut made on the skin and a biopsy device will be inserted into the breast, and samples of tissue will be removed.

If you are having a stereotactic breast biopsy, you will lay face down on a table that has a hole in it. Your breast will come through the hole. You will be placed in compression and images will be taken in order to confirm location of the microcalcifications or mass. When the mass is localized, the procedure proceeds in the same manner as described above. The small incision is closed with a small tape or band-aid.

The advantage of a minimally invasive biopsy is we can get the same information with a less invasive procedure. For women with fibrocystic breasts, it can mean less scarring. For a woman diagnosed with breast cancer, it can mean fewer trips to the operating room. If you require a biopsy, seek a surgeon or radiologist who performs this procedure.