Methods of Breast Biopsy

Image courtesy of Siemens Medical.

Several methods of breast biopsy now exist. The most appropriate method of biopsy for a patient depends upon a variety of factors, including the size, location, appearance and characteristics of the breast abnormality. Click on one of the biopsy methods below for a detailed explanation of the procedure.

Overview:

• Summary and Illustrations of Biopsy Methods

Biopsy Methods:

• Fine Needle Aspiration (FNA)
• Core Needle Biopsy
• Vacuum-Assisted Biopsy (Mammotome or MIBB)
• Large Core Biopsy (ABBI)
• Open Surgical Biopsy (Excisional and Incisional)

Summary and Illustrations of Biopsy Methods

Summary of Breast Biopsy Methods
Type	Used For	Needle Sample size	Anesthesia	Pros	Cons
Fine Needle Aspiration (FNA)	Cysts; sometimes also used to sample cells from masses with or without calcifications	22 or 25 gauge needle; several (5-6) samples of fluids and/or cells are removed	Local or none	Fastest and easiest method; results rapidly available; no stitches or scar; excellent for cysts	Small sample size may cause incomplete assessment or misdiagnosis; multiple needle insertions; operator dependent
Core Needle	Sample tissue from solid mass or calcium deposits	10, 11, or 14 gauge needle; several (5-6) samples are removed	Local	Larger sample than FNA can lead to more accurate diagnosis; no stitches or internal scar	Multiple needle insertions; limited sample size may underestimate more serious diagnosis
Vacuum-Assisted (Mammotome or MIBB)	Primarily used for calcifications	11 or 14 gauge needle. Requires 0.25 inch incision (approx. 0.6 cm); several (8-10) samples are removed	Local	Excellent for calcium deposits; removes several large samples with one needle insertion; no stitches; minimal scar	May be less accurate than surgical biopsy which removes entire lesion; not ideal for hard-to-reach lesions (i.e., near chest wall); operator dependent
Large Core Surgical (ABBI)	Primarily used for nonpalpable (unable to feel) masses and/or calcifications	5mm-20mm to cylinder of breast tissue is removed (approx. size and shape of wine cork)	Local	Provides large sample without heavy sedation (as with surgical biopsy)	Removes large amount of normal tissue before reaching lesion, may not remove adequate margin of tissue around lesion; requires stitches; scar
Open Surgical	Masses, hard-to-reach lesions, (i.e. near chest wall) multiple lesions; masses with micro-calcifications	Requires 1.5 to 2 inch incision (approx. 4.0 to 5.0 cm); golf ball size area of tissue or more is removed	Heavy sedation; sometimes general anesthesia	Yields largest tissue sample; most accurate method of diagnosis (near 100%)	Causes permanent scar that may make future mammograms difficult to read; possible breast disfigurement; requires stitches and longer recovery

Updated: May 4, 2008