My doctor inserted a needle in my breast and was not able to get any sample. Now he says I need a proper biopsy. Is he for real?

Sometimes the doctor is not able to get enough tissue samples using a needle biopsy and thus another biopsy technique is required. A breast core biopsy procedure utilizes a large size needle to biopsy the mass. In addition, the procedure is done in the presence of an ultrasound or mammogram so that the needle can be guided to the core of the breast mass. Core biopsy of the breast is done as an outpatient procedure. At the radiology clinic, you will be asked to lie down on a table. Images of the breast are obtained with a mammogram or ultrasound and then the needle is carefully guided to the center of the mass. This method ensures that the sample will be obtained directly from the abnormal area of the breast. Unlike the needle biopsy, breast core biopsy do have a tendency to cause bleeding, bruising and mild pain.

How is a needle biopsy done?

A breast needle biopsy is done in a doctor’s office. The doctor usually cleans the skin overlying the breast and may also numb the area with a local anesthetic.  A small needle is then placed into the breast mass and the contents are aspirated. All women should understand that with a breast needle biopsy there are only a few cells obtained. The cells are smeared onto a slide, which is then sent to the pathologist to determine if they look abnormal.

I am 43 years old and have a 1 cm left breast mass. My doctor says I need a needle biopsy. Is this necessary?

Women who have a mass often need to undergo a breast biopsy. There are many types of breast biopsy procedures for women who have a breast mass.  It is impossible to tell if a mass is a cancer just by examining the breast with the hands. The only definitive way to confirm a cancer is to perform a breast biopsy and send the tissue to the pathologist for examination. In your case, a needle biopsy is fine.

I am 44 years old and have a 4 cm right breast mass. My doctor says I need a surgical biopsy. Is this really necessary

Some patients with a large breast mass may need to undergo an open surgical biopsy. Surgical biopsy of the breast may be performed under local or general anesthesia. Surgery requires a small incision and a biopsy can be easily obtained. In the past most breast biopsies were performed using surgery but today the development of ultrasound and MRI has led to demise of surgery to obtain biopsies. Perhaps you can ask your doctor about a needle biopsy first. 

It is highly recommended that any women with an unknown breast mass undergo some type of breast biopsy procedure to confirm the identity of the lesion.

I am a 35 year old female and often find that the chest wall and ribs surrounding my breast are sore. What do you think is going on?

Some women tend to develop breast swelling tenderness that is not cyclical. The pain in the breast is often localized to one area and may have occurred from trauma, infection or from a large cyst. Often this type of pain is worsened in women who take supplementary hormones. Other causes of breast pain may be related to the chest wall and ribs. Some young women often develop intense pain that is felt when the bony surface of the chest is touched- this is referred to as costochondritis. This type of pain has no cyclical pattern, often worsens with a deep breath and in most cases spontaneously disappears.

I am a 29 year old female who develop breast pain just before the beginning of my menstrual cycle. Is this normal?

In some women, the breast tenderness pain is cyclical. This type of cyclical pain is usually observed in younger women less than 35 and affects close to 40 percent of individuals. It is believed that hormonal changes that occur during the menstrual cycle are responsible for the breast swelling and pain. The fluid retention that occurs just prior to the menstrual cycle often causes the breast to feel swollen and painful. As soon as the menstrual cycle is over, the pain immediately disappears. So far, the use of water pills and reducing sodium in the diet has not been shown to relieve this pain or breast swelling. Most women, however, do get relief from a non-steroidal anti-inflammatory dry like Motrin.

I am a 33 year old female and have persistent pain in my left breast. Can this be due to a cancer?

Breast tenderness causes a lot of anxiety in many women. The one major misconception women have is that breast cancer is associated with pain. In fact, it is extremely rare for cancer of the breast to present with pain. The majority of women with breast cancer have no pain. Breast pain has many causes and is often referred to as mastalgia or mastodynia. Close to 70% of women, experience some type of breast swelling tenderness at some point in their lives. This pain usually lasts 3-5 days per month and can be distressing. You can rest assured that pain last a few days is rarely cancer.