What is an incisional breast biopsy?

An incisional breast biopsy is a procedure in which the doctor surgically removes part of a lump found in your breast for testing.

When is it used?

The biopsy is done to check if the lump is benign or cancerous. This type of biopsy is used only in cases in which the lump is too large to be removed completely without a more major surgery such as a mastectomy.

If no cancer is found, you may need to have a more thorough biopsy to make sure the entire lump is benign.

An example of an alternative is a needle core biopsy (taking samples from the lump with a needle).

You may choose not to have a biopsy, recognizing the risks of not knowing your condition. You should ask your doctor about these choices.

How do I prepare for an incisional breast biopsy?

Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow instructions provided by your doctor. No special preparation is needed for local anesthesia. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a local or general anesthetic. A local anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

The doctor will make a small cut in your breast and remove a sample of tissue. He or she will send the sample to the lab and sew the cut closed.

What happens after the procedure?

After you have recovered from the anesthesia, you may be observed for a few hours and then go home. During this time, an analysis may come back from the lab and the doctor may explain what the lump probably is. This analysis is the result of only one test and may not be 100% accurate. In about 2 days, the lab may complete its testing on the lump, and the doctor may then be more certain what the lump is.

Ask the doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

This procedure will help the doctor make an accurate diagnosis and recommend treatment if necessary.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A local anesthesia may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.

• A lumpy scar called a keloid could form in the area of the incision.

• There may be infection and bleeding at the site of the incision.

You should ask your doctor how these risks apply to you.

A disadvantage of this biopsy is that the entire lump has not been removed. It will usually require additional treatment or surgery.

When should I call the doctor?

Call the doctor immediately if:

• There is drainage from the wound.

• You develop a fever.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.