Women's Imaging

What is Ultrasound Guided Breast Biopsy?

Ultrasound is an excellent way to evaluate palpable breast lesions or abnormalities detected by mammography. In some cases, it is not possible to determine from the imaging studies alone whether a growth is benign or cancerous. Ultrasound-guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast that are visible on ultrasound, regardless of whether they are palpable. The procedure replaces the need for open surgical biopsy. After localizing the abnormality with ultrasound, local anesthesia is used to numb the skin and underlying tissues. A tiny skin incision is made. Under ultrasound guidance, the radiologist introduces a biopsy needle directly into the mass. Tissue specimens are then taken using either an automatic spring-loaded or a vacuum assisted device (VAD). With vacuum assistance, sometimes the entire lesion can be removed from the breast, with a small metal clip inserted in its place to help localize the area if further intervention is needed. The tissue is then sent to the pathologist for laboratory analysis. After the procedure, it is not necessary to close the tiny skin incision. A small compression dressing will suffice. Manual pressure and an ice pack are held over the biopsy area. After a short period of observation, the patient is sent home with a sports bra for support. Patients are instructed to avoid strenuous activity for 24 hours after returning home, but then will usually be able to resume their normal activities.

How should I prepare for the procedure?

Although ultrasound-guided breast biopsy is minimally invasive, there is a risk of bleeding whenever the skin is penetrated. For this reason, if you are taking aspirin or a blood thinner, your physician may advise you to stop them three days before the procedure. Also, if you ever require antibiotic prophylaxis for a dental procedure, colonoscopy or other medical procedure because of a heart valve problem, you should ask your physician to place you on the appropriate antibiotic regimen prior to, and after the procedure. Finally, a breast biopsy always raises the concern about cancer. You may want to have a relative or friend present to lend support, and also to drive you home afterwards.