If it is determined that you do have a lump or mass inside your breast that needs further evaluation, a biopsy will be required. In the type of biopsy performed at Ko'olau Radiology, small samples of tissue from areas in question are removed and tested. This can be a scary time, but it does NOT mean you have cancer. Biopsies are performed when the doctor needs to determine whether an area of concern is a cancer, or if it is a benign condition that looks like a cancer. Once the biopsy is performed, the tissue specimens will be reviewed by a pathologist to determine if the tissue is benign or cancerous. We typically receive the results of the pathology examination within 24-48 hours of the biopsy and will communicate those results to your doctor as soon as possible.
There are three methods to perform biopsies. These include stereotactic biopsy, ultrasound guided biopsy, and open surgical biopsy. At Ko'olau radiology we currently utilize the ultrasound guided biopsy technique. Stereotactic biopsies and open surgical biopsies are performed in a hospital setting.
Ultrasound guided biopsy
What is ultrasound guided breast biopsy?
Ultrasound-guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast that are visible on ultrasound, whether or not they can be felt on clinical examination. After placing an ultrasound probe over the site of the suspicious area, and injecting a local anesthetic, the radiologist guides a specialized biopsy needle directly into the mass and removes one or more tissue samples. These samples are presented to the pathology department for evaluation.
When is ultrasound guided biopsy utilized ?
Ultrasound guided biopsy may be recommended if an area of concern is found in your mammogram or ultrasound exam, and it is of a type best approached using ultrasound guidance. Ko'olau Radiology radiologists use this technique to remove samples of tissue from an area in your breast that needs further examination. The sample will then be sent to pathology for evaluation in the same manner as for other biopsy procedures.
How should I prepare for the procedure?
You will need to let us know at the time you make your appointment about any over-the-counter prescription medication that you are taking. If you have been taking daily aspirin or use ibuprofen (Advil, Motrin) or Aleve on a regular basis we will ask you to discontinue using these medications for as many as five days prior to the procedure. If you take warfarin (brand name Coumadin), we will consult with your physician above possibly discontinuing this medication for the period of the biopsy. We will have you discontinue these drugs to prevent possible bleeding complications.
How is the procedure performed?
You will be placed on your back or turned slightly to the side and the ultrasound probe will be used to locate the lesion. A local anesthetic is injected to be sure that you will feel no discomfort during the procedure. A small nick is made in the skin at the site where the biopsy needle is to be inserted. A Ko'olau radiologist will constantly monitor the lesion site with the ultrasound probe and guide a specialized biopsy needle directly into the mass to obtain the tissue samples. Multiple tissue samples will be obtained and submitted for pathologic analysis.
What will I experience during the procedure?
You will be awake during your biopsy and should have little or no discomfort. Generally, the biopsy will be completed in less than an hour. It is not necessary to close the tiny skin incision with sutures. A Steri-Strip dressing is used to close the skin and a small waterproof dressing will be applied that will allow you to take showers until the skin nick has healed typically in four days. Most patients are able to resume their usual activities later the same day. You will be asked to return the following day for the radiologist to reassess the biopsy site and provide any further medication or assistance as required.
Who interprets the results and how do I get them?
Koolau sends the tissue specimens to the Queens Medical Center pathologist for interpretation, and typically receives the report of that interpretation within 48 hours of the procedure. There will also be a copy of this report forwarded to your physician.
Mass as seen on ultrasound
Mass as seen on ultrasound with biopsy needle
1380 Lusitana Street, Suite 200, Honolulu, HI 96813