Excisional Breast Biopsy

WHAT YOU SHOULD KNOW:

• An excisional breast biopsy is a surgical procedure to remove a mass (lump) from your breast. This procedure may also be called a lumpectomy. An excisional breast biopsy is done to diagnose one or more lumps in the breast. The mass and tissue sample is sent to a lab and checked for cancer. Most breast lumps are benign (not cancer). If the tissue sample shows cancer, you and your caregiver may learn the type of cancer you have. Most breast cancers, and other breast problems, occur in women but can also occur in men.
  
  
• An excisional breast biopsy may be done if you had a mammogram (breast x-ray) or another imaging test that showed a mass. You may need an excisional breast biopsy if you or your caregiver felt a mass during a breast exam. You may also need the procedure if you have a breast mass that has gotten bigger or has changed its shape. An excisional breast biopsy may be done if you have swollen or abnormal dry areas on your breast. A breast biopsy may be done if you have breast pain or discharge (fluid) from your nipple. If a needle breast biopsy showed abnormal cells in your breast, you may also need an excisional breast biopsy. An excisional breast biopsy may help you learn the cause of your breast mass or other symptoms. Learning the cause of your breast problem will allow you to get the proper treatment. If you have breast cancer, the sooner it is found, the easier it may be to treat. Learning you have breast cancer, and getting treatment, may help prevent the cancer from spreading.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• You may have an allergic reaction to the anesthesia medicine used for your procedure. The tissue sample taken may not have the mass in it, and you may need another biopsy. If a guidewire is used to locate your breast mass, the guidewire may move out of place. Nerves near your breast may be damaged during the procedure, causing you to have decreased feeling in your breast. After your biopsy, you may have pain in the area where the biopsy was done. You may have nausea, vomiting (throwing up), weakness, and dizziness. Your wound may bleed, your breast may bruise and swell, and you may get an infection. Your breast may have a different shape after removing the mass.
  
  
• If you do not have an excisional breast biopsy, you may not learn if the breast mass is cancer. Your caregiver may not be able to plan the best treatment for you. If you have breast cancer, it may spread to other areas of your body, and you may die. Talk with your caregiver if you have questions or concerns about your procedure, condition, or care.

WHILE YOU ARE HERE:

Before your biopsy:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Tests:
  
  
  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
    
    
  • Urine sample: A sample of your urine may be collected and sent to a lab for tests.
  
  
• Pre-op care: You may have an ultrasound or mammogram before your procedure to find the exact location of your mass. An ultrasound is a test that uses sound waves to show the inside of your breast on a screen. Caregivers may use a guidewire to show the location of the mass. A needle and guidewire is put through your skin until it reaches your breast mass. A mammogram is done after the guidewire is placed to make sure it is in the right area. You may be given medicine right before your procedure to help you feel relaxed and sleepy. You are taken to the room where your procedure will be done. You will sit or lie down on a table or bed with your arms at your sides.
  
  
• Anesthesia medicine: Anesthesia is medicine to make you comfortable during your procedure. You and your caregiver will work together to decide the best anesthesia for you. You may get any of the following:
  
  
  • Local or monitored anesthesia: This is a shot of numbing medicine put into the skin where you will have your procedure. You may still feel pressure or pushing during the procedure, but you should not have pain. With local anesthesia, you will be awake during the procedure. With monitored anesthesia care, you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the procedure.
    
    
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your procedure:

Caregivers clean the area of your skin where the procedure will be done. An incision (cut) is made in your breast, and your caregiver removes the breast mass. A small amount of tissue around the mass, called a margin, will also be removed. The tissue is sent to a lab for tests. Caregivers may x-ray the tissue taken to make sure the entire mass was removed. Your cut is closed with stitches, and a bandage is put over your wound (procedure area). The bandage keeps the area clean and dry to help prevent an infection.

After your procedure:

You may be taken to a room where you can rest. Caregivers will check your wound for bleeding. Do not get out of bed until caregivers say it is okay. When caregivers see you are not having any problems, you may be able to go home. Caregivers will make sure you can drink liquids or eat without feeling nauseous (sick to your stomach). Caregivers may also get you up to walk and make sure you have urinated before you can go home.

• Medicines:
  
  
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    
  
  
• Ice: Caregivers may put ice over your wound to help decrease pain or swelling.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.