Ultrasound Core Biopsy

In some cases, doctors may require biopsies to determine whether masses are malignant or benign. Technicians at the Caldwell Breast Center at Lutheran General Hospital can perform highly accurate, minimally invasive ultrasound-guided core biopsies without surgery or radiation exposure from x-rays.

• What is an ultrasound core biopsy?
• How do I schedule the test?
• What happens during the test?
• How do they take the tissue samples?
• What happens to the tissue samples taken during the test?
• Are there activities I won't be able to do after the biopsy?
• Will it be painful?
• How long will it take?

What is an ultrasound core biopsy?
Ultrasonagraphy uses high frequency sound waves to image internal structures in the breast. This is an excellent way to further evaluate breast abnormalities that may have been found by you, your doctor, or detected on your mammogram.

How do I schedule the test?
A nurse will schedule you for your biopsy. You will also see a surgeon, recommended by your primary care doctor, so that he or she can perform a clinical breast exam after viewing your mammogram and ultrasound images. This doctor will write the order or referral for the procedure. There are times that another procedure may be in your best interest and this will be discussed with you at your appointment with the surgeon.

What happens during the test?
During the biopsy you will be positioned on your back or turned slightly to your side. An ultrasonographer and nursing assistant will assist the radiologist during your biopsy.

First, the skin of your breast is cleansed with a special soap called Chloraprep. The ultrasound probe, or transducer, is then placed over the area in question. A warm, gel-like substance will be applied to your skin. This gel helps the sound waves travel through the breast.

After locating the area of concern, a local anesthetic called lidocaine, which is similar to what your dentist uses, is injected into and around the area to be biopsied. A small nick is made in the skin and the radiologist will then guide the biopsy needle into the area of concern by constantly monitoring the needle track on the ultrasound monitor screen.

After the tissue samples are taken and the needle is removed, your nurse will hold pressure to the biopsy area to decrease the chance of bleeding and bruising. Small butterfly tapes (steri-strips) are then applied to the small skin nick and then a gauze bandage. A small gel ice pack is applied to decrease the chances of swelling and bruising. An additional ice pack will be sent home with you.

How do they take the tissue samples?
Tissue samples are taken using either an automatic or vacuum-assisted device. Usually four to eight samples are taken. A tissue marker is placed at the biopsy site to mark the area. This stainless steel or titanium clip is used to provide a landmark for watching for changes in the breast. This marker is MRI compatible. It will not set off any metal detectors either!

Occasionally, an additional mammogram is needed after the biopsy to document clip verification.

What happens to the tissue samples taken during the test?
The tissue samples are sent to pathology for careful study. These results are available to your surgeon in two to three business days. The breast health educator is also available to help you follow up on your surgeon’s recommendations.

It is not always possible to know whether a growth in the breast is cancerous, although the majority of breast biopsies, around 80%, are found to be negative or benign.

Are there activities I won’t be able to do after the biopsy?
Restrictions include not lifting anything over five pounds for 24 hours and no swinging or pushing with the side of the body on which the biopsy was performed. Before leaving you will be assessed by a breast health educator and provided verbal and written post biopsy instructions.

Will it be painful?
Biopsies may be mildly uncomfortable, but are rarely painful. Pain relievers such as acetaminophen or ibuprofen and warm compresses will alleviate any lingering discomfort.

How long will it take?
An ultrasound core biopsy will take from XX to XX minutes and no special preparation is required, but if you’re pregnant you should notify the technician to be sure you’re adequately protected from the x-rays used in the procedure.