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.

Getting Ready

The week before your procedure:

• Ask someone to drive you home when you are ready to leave the hospital. Do not drive yourself home after your procedure.
  
  
• Ask your caregiver if you need to stop using aspirin or other over-the-counter or prescribed medicines or supplements. This includes medicines that thin your blood, non-steroidal anti-inflammatory medicines (NSAIDs), vitamin E, and some herbal supplements.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Tell your caregiver if you know or think you might be pregnant.
  
  
• You may be told to bring a support bra, such as a sports bra, with you to your procedure. You will need to wear the support bra at all times while your breast heals. The support bra will help decrease breast movement and discomfort after your procedure.
  
  
• You may need blood or urine tests and imaging tests. Imaging tests include an ultrasound of your breast and a chest x-ray. An ultrasound is a test that uses sound waves to show the inside of your breast on a screen. Talk with your caregiver about these and other tests you may need. Write down the date, time, and location for each test.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• Caregivers may use a guidewire to show the location of the mass. A needle and guidewire will be 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.
  
  
• An anesthesiologist may talk to you before your procedure. This caregiver may give you medicine to make you sleepy before your procedure. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past. Anesthesia is medicine to make you comfortable during your procedure. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment.

Treatment

What will happen:

• You may have an ultrasound or mammogram before your procedure to find the exact location of your mass. A guidewire may be placed in your breast to mark the location of the mass. You will be 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. You may get a shot of local anesthesia medicine to numb the area where your procedure will be done. You may also be given general anesthesia to keep you completely asleep during the procedure.
  
  
• Caregivers will clean the area of your skin where the procedure will be done. An incision (cut) will be made in your breast, and your caregiver will remove the breast mass. A small amount of tissue around the mass, called a margin, will also be removed. The tissue will be sent to a lab for tests. Caregivers may x-ray the tissue taken to make sure the entire mass was removed. Your cut will be closed with stitches, and a bandage will be put over your wound (procedure area). The bandage will keep 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. If you have pain, you may be given medicine to take away or decrease your pain. 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.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You are late or cannot make it to the procedure.
  
  
• You have a fever.
  
  
• The mass in your breast gets bigger, or your breast changes size or shape.
  
  
• You see changes in the skin of your breast, such as an orange-peel look to your skin.
  
  
• You have new or increased drainage from your nipple. The drainage can be clear, white, yellow, or bloody.

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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.