- The doctor or doctor's assistant reviews the risks and benefits of the biopsy procedure and asks you to sign a consent form.
- The doctor or assistant cleans and sterilizes the area of the skin where the needle will be inserted or the incision will be made.
- You can expect to receive a local anesthetic to numb the area from which samples will be taken or a general anesthetic to "knock you out." The local anesthetic may cause a burning or stinging sensation when it goes in, but the pain won't last long. It's important to numb the area up first so the procedure will be more comfortable. (You're more likely to need a general anesthetic if you're undergoing a surgical biopsy.) You may also receive a sedative, so you'll feel groovy during the procedure.
- You may be instructed to sit up or lie down on your back, on your side, or face down on a special table. Again, this varies depending on the type of biopsy. (Diagnostic imaging equipment may be used to help your doctor locate the tissue to be biopsied.)
- The doctor performing the biopsy may need to make a very small incision to gain access to the tissue that needs to be biopsied. If you're having a surgical biopsy, a longer incision may be required.
- The doctor inserts the needle into the tissue to be sampled, extracts a core sample, and places it in a preservative or formalin to be sent to the pathologist. (This step is repeated approximately three to five times to obtain additional samples.)
- The doctor places a tiny metal or titanium clip at the biopsy site to mark it for future examination or surgery, if necessary. The clip will appear on diagnostic images, but you will probably not notice it. It's important to have this clip inserted because it provides a map to the site that was biopsied in the breast, should it need to be sampled again in the future.
A small percentage of patients don't want anything "left" in their bodies, as they feel this will cause them pain or harm. But having this spot marked with a clip is very helpful for future mammograms so that the area with the abnormality can be monitored over time (if it's not all surgically removed).
- If an incision was made, the doctor closes it with sutures or adhesive strips and applies dressing. If no incision was made, the doctor applies pressure and possibly a cold compress to stop the bleeding and then dresses the puncture site.
- To wrap things up, the assistant is likely to take you back to an observation area for several minutes to make sure you're doing okay before you're released. You may obtain oral or written instructions on how to care for the wound, when to schedule a follow-up visit, and when to expect the results.
If you're not told, ask when you can expect to receive the results, from whom the results will come (radiologist, surgeon, primary care physician, nurse practitioner), and in what form — phone call or in writing. If you have a preference for how you receive the results, let it be known; the medical center has its own procedures but may make an exception upon request.