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JSASA Breast Surgery, Breast Biopsy, Breast Cancer

One of our primary focuses at JSASA is the treatment of breast disease, breast biopsies and breast cancer. We perform a number of procedures including:

  • Routine & high-risk screening for breast cancer
  • Needle aspiration breast biopsy
  • Sentinel lymph node breast biopsy
  • Breast-sparing procedures
  • Mastectomy (complete breast removal)
  • Lumpectomy (breast lump removal)
  • Fibrocystic surgery
  • Complex cyst surgery
  • Benign lesion surgery
  • Breast infection surgery

Breast Biopsy Techniques

When we detect an abnormality in the breast, either by examination or mammogram, we often recommend a breast biopsy. Your surgeon will choose the biopsy approach that is most appropriate for you based upon the nature and location of the abnormality. Some abnormalities require a surgical approach for complete evaluation, while others may be evaluated with a needle biopsy.

Stereotactic (Mammotome) Breast Biopsy

A needle biopsy (either a fine needle aspiration biopsy or a core needle biopsy) involves placing a needle into the abnormal area to remove a small amount of tissue for analysis. If there is a lump that can be felt, your surgeon may be able to do this type of biopsy in the office. If the abnormality is not palpable, or if it is deep in the breast, we can perform a needle biopsy using either ultrasound guidance or a stereotactic biopsy. The ultrasound or stereotactic mammogram images allow for precise placement of the needle. We do needle biopsies that require local anesthesia, take very little time and usually cause only mild discomfort.

When an abnormality can only be seen by mammogram, we may do a stereotactic core biopsy. This is sometimes called a Mammotome biopsy. Mammotome is the brand name for the equipment. We perform this biopsy with a special, automated needle and a sophisticated computer guidance technique based upon mammogram images. The stereotactic biopsy equipment is located in the Breast Imaging section of the Radiology Department at Hartford Hospital. If we recommend this procedure for you, we will make your appointment at Hartford Hospital.

What To Expect During A Stereotactic Biopsy

During the examination, the lights in the room will be dimmed and you will be asked to lie on your stomach on a specially designed table. There is an opening in the table for your breast. We perform this procedure using a mammography unit mounted underneath the table. We first obtain several localizing mammograms to confirm the area to be biopsied. We administer local anesthesia and perform the biopsy. With each sampling you will hear a click and feel a bit of pressure. Most women do not feel any significant pain. This procedure typically takes about one hour.

You can expect some discomfort, bruising and swelling after a needle biopsy. Most patients experience mild symptoms. Applying ice to the breast (on and off, no more than 30 minutes at a time) can help reduce bruising and swelling. You may use Tylenol (2 tablets every 4 hours) or Ibuprofen (1 tablet every 4 hours) for the discomfort. Most women also find that a supportive sports-type bra makes them more comfortable for the first 24 hours (overnight). It is usually not necessary to restrict your activities after a needle breast biopsy. As long as you feel well, you may resume your normal schedule. Bruising typically resolves in 5 to 7 days.

Surgical Biopsy

When a breast lesion needs removal or a needle biopsy cannot provide enough tissue for analysis, we perform a surgical biopsy in an operating room. The surgeon removes the abnormal tissue in order to accurately diagnose the abnormality.

Surgical breast biopsy is an outpatient procedure. Your surgeon will decide which type of anesthesia is most appropriate for keeping you comfortable during the biopsy procedure. We may use local anesthesia, local anesthesia combined with intravenous sedation, or general anesthesia. If you have intravenous sedation or general anesthesia, you will spend some time in the recovery room before you can go home.

Risks and complications of a surgical breast biopsy include infection, bleeding, bruising, hematoma (a blood clot near the surgery) and seroma (a fluid collection near the surgery). There may also be a change in the appearance of the breast as a result of the procedure.

Needle Localization (Wire Localization)

If we cannot feel the abnormality on examination, we will do a surgical biopsy with needle localization. We perform needle localization, sometimes called wire localization, in the radiology department just before your scheduled surgery. The radiologist identifies the abnormal tissue using mammograms, ultrasound or MRI (whichever technique shows it best).

Using local anesthesia, the radiologist inserts a small needle into the area of concern. We confirm the location then pass a thin, flexible wire through the needle. We remove the needle and tape the wire to your breast. We take one final set of mammograms to ensure that the wire is located in the correct area. You are then sent to the operating room, where your surgeon uses the wire and X-rays to locate and remove the abnormality.

How To Prepare For Your Breast Biopsy

THE WEEKS BEFORE:

  • Unless otherwise directed by the nurse or doctor, DO NOT TAKE ASPIRIN OR IBUPROFEN (such as Motrin), vitamin E or any medications that thin your blood.
  • Do not take any herbal or diet medication for two weeks prior to surgery.

THE DAY BEFORE:

  • Unless otherwise directed by the nurse or doctor, DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT.

Things to Consider

  • You will be discharged the same day as your surgery
  • You may experience some weakness, lightheadedness, or sleepiness afterward
  • You will need a responsible adult to drive you home
  • You should not drink alcohol, drive or make important decisions for 24 hours
  • You can expect bruising, swelling, fatigue and pain after a surgical breast biopsy
  • You will receive a prescription for pain medication
  • You may also take ibuprofen or Tylenol for mild or moderate discomfort.
  • You can apply ice to your breast during the first day after surgery to reduce pain and swelling
  • You will probably feel more comfortable wearing a bra
  • The day after surgery you may remove the gauze bandage and shower. It’s okay to get the incision wet and then pat it dry with a clean towel. It is best to avoid baths, hot tubs and swimming for a week. The steri-strips will start to curl up and fall off in 7 to 10 days.

    You may resume most normal activities as soon as you feel able. You will want to avoid jogging and jumping for at least a week. Bouncing your breasts will likely be very uncomfortable. Most patients are more comfortable wearing a bra even to sleep. You should not drive while you are taking pain medication!

    Mastectomy or Lumpectomy?

    Many factors will determine which procedure is best for you. Your surgeon will explain your treatment options and risks before performing a mastectomy or lumpectomy and discuss your personal preferences.

    Discover exceptional breast surgery at JSASA. Call 732-775-5005 or use our convenient Request an Appointment form.

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