Ultrasound-guided core biopsy is a procedure to locate and biopsy abnormal areas in the breast that cannot be felt. The areas in question are located by ultrasound.

Ultrasound uses sound waves to detect changes in density within the breast tissue and locates solid masses or cystic masses within the breast. Ultrasound does not detect the microcalcifications in the breast that are best seen on mammograms. The abnormalities that are seen on ultrasound that are most concerning are solid masses within the breast and frequently these densities can also be seen on mammography. The majority of lesions seen on ultrasound are benign. In cases where a cancer is diagnosed by ultrasound or mammography and cannot be palpated, the cancer is usually small and in its early stages. Early diagnosis of breast cancer provides the patient with the best opportunity for cure.

Ultrasound-guided core needle breast biopsy is performed on a horizontal table with the patient lying on her back. Ultrasound examination of the breast is performed by the surgeon to locate the abnormal area in the breast. Once the area of the abnormality in the breast is located, the skin surrounding the area is marked to aid the surgeon in planning the direction of the needle being inserted into the breast.

Lateral to where the abnormality is visualized, the breast is cleaned with an antiseptic solution. Local anesthesia is administered in the skin and deeper into the breast tissue with a needle. When this area of the breast is numb, a small incision is made in the breast and the larger biopsy needle is passed through the incision. Using the ultrasound for guidance, the needle is placed directly under the ultrasound abnormality. Under direct ultrasound visualization, multiple small slivers of breast tissue are removed through the needle and usually the abnormality can be seen to disappear as the pieces of tissue are removed on ultrasound.

After completion of the biopsy, a small stainless steel clip is left at the biopsy site through the needle to identify where the biopsy was performed on future mammograms and ultrasounds. The entire procedure takes less than an hour.

After the procedure the patient can return to usual activities. We do recommend that strenuous activities be avoided for at least 24 hours after the procedure.

A final diagnosis is usually available from the pathology department in 3-7 days. A followup mammogram and ultrasound of the breast is usually performed six months after the biopsy.

In a few instances, the lesion in the breast cannot be well visualized and this procedure may not be able to be performed. In these cases, the procedure may need to be rescheduled as an open procedure through an incision.

The major advantages of this procedure over an open breast biopsy are as follows: The procedure is performed under local anesthesia without a need for intravenous sedation or general anesthesia. A Valium tablet can be administered 2 hours before the procedure to relax the patient. If Valium is used, a driver is required. The incision is very small, about 1/8 inch. Possible complications from any breast biopsy include bleeding, infection, pain, scar formation, and deformity. This procedure minimizes these risks. The procedure is performed in a comfortable position with the patient lying on her back. The procedure can be performed either in the office or at the surgical center.