Core Needle Biopsy
Who Is a Good Candidate?
Most patients are good candidates for a core needle biopsy. Rare exceptions are those where local anesthesia does not work or severe patient anxiety. Some lesions are located in locations in the breasts that make core needle biopsy technically difficult and risky for the patient and these cases are referred for surgical excision. Core needle biopsy is just as accurate as surgical excision and avoids a surgical procedure in the majority of patients who have benign findings and do not require surgery. Core needle biopsies ae usually performed with imaging guidance using ultrasound, mammography or MRI but sometimes can be guided by palpation for larger lesions. The most common and simplest approach is using ultrasound, which Dr. Schwartz performs in his office.
Consultation and Procedure
During your consultation, Dr. Schwartz will evaluate your imaging and decide whether you’re a good candidate for an ultrasound guided or palpation guided core needle biopsy. He will then schedule a separate appointment for the procedure. This procedure is performed in the office by Dr. Schwartz with just local anesthesia to obtain a diagnosis of a solid mass that is seen on ultrasound. This minimally invasive procedure avoids a surgical operation and general anesthesia to obtain biopsy results. The breast is numbed with lidocaine anesthesia (similar to a dental procedure) and a small needle is introduced into the breast under ultrasound guidance to take several samples of the mass in question. Usually, a small metallic clip is left in the breast where the biopsy was performed for possible future surgery or mammographic follow-up. The procedure is usually done first thing in the morning and lasts about 10 minutes. Patients can drive to and from the procedure by themselves. A bandage is placed over the wound.
Recovery and Results
Recovery is immediate and patients can return to work the same day without activity restrictions. The bandage stays on for 48 hours and is then removed but patients can shower on the day of the biopsy. Patients follow-up in the office the next week to discuss the biopsy results. Often patients can just return to their annual screening mammogram or may have a 6 month follow-up recommended. Some patients may have benign findings on core biopsy but may still be recommended to undergo a surgical excision to ensure that the core needle biopsy results do not underestimate the extent of disease in the breast and miss a cancer. Malignant results usually require additional testing and surgical planning by Dr. Schwartz with referrals to both medical and radiation oncology.