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Tests: Needle Localization Biopsy

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The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 18, 2009

About Needle Localization Biopsy

This "Helpful Facts" sheet is designed to give you basic information on needle localization biopsy. More detailed information can be provided by your doctor or nurse. If, you have other questions or would like additional information, please talk to your doctor or nurse.

What is a breast biopsy?
A biopsy is a surgical procedure that removes a sample of tissue from the body. The tissue is then examined under the microscope by a pathologist to determine if there is cancer present. Pathologists are physicians who are specially trained to diagnose diseases using tissue or other samples from the body.

When is a needle localization breast biopsy recommended?
A needle localization biopsy is done when an abnormality is seen on mammogram but no lump can be felt on physical exam. The biopsy is used to make a precise diagnosis and develop a treatment plan that is best for you.

What is a needle localization biopsy and how is it done?
A needle localization biopsy involves the removal of the entire lump, or area of concern, in your breast. This is usually done as an outpatient procedure (Ambulatory Procedure Unit). You will start the day in Radiology where the radiologist uses mammography or ultrasound to guide the needle into the area of concern. The needle is then removed and a flexible wire is left in place in your breast. This is called "needle localization". The wire is then covered with a dressing to hold it in place. The average time for this part of the procedure is 30-60 minutes. You are then taken to the operating room where you will receive a local anesthetic to numb your breast, as well as, sedation through a needle in your arm to make you sleep through the procedure. The surgeon uses the wire as a guide to precisely locate the lump. An incision (cut) is made and the abnormal tissue, along with the wire, is removed. The tissue is then sent to pathology for review. When the surgery is complete, a dressing is placed over the incision and you are taken to the post anesthesia care unit (PACU) to recover. In general, you can expect to be in the operating room for 60 to 90 minutes and in the PACU for about 1-2 hours.

What are the risks of this procedure?
All surgery involves risk. Your surgeon will discuss the risks of the biopsy with you. There can be some scarring or change in the shape of the breast, depending on the size and location of the lump.

Your surgeon will discuss what you can expect. Other risks and complications associated with breast surgery are listed below:

• Wound infection: Infections are not common but when they occur they are usually easily treated with antibiotics
• Poor wound (incision) healing: Although uncommon, blood and/or clear fluid can collect in the breast/wound area. This might require drainage of the blood or fluid.
• Bleeding: Bleeding during or after a biopsy is rare
• Reactions to anesthesia: There are always risks associated with anesthesia, such as breathing problems or a reaction to the medications used for anesthesia. However, these risks are low.

When do i learn the results?
It takes approximately 5 to 7 working days to get pathology results. The results will be discussed with you at your first post-operative visit.

Post-operative Instructions for Needle Localization Breast Biopsy

Francis Spitz, MD

1. You may wish to bring a bra with you to wear when you go home. Most people prefer a soft cotton, stretch bra, or athletic bra. Some women also find it comfortable to wear the bra when sleeping.
2. You will have a dressing on the area of the incision. Please leave this clean and dry for 48 hours. After 48 hours you may remove the bandage and shower (you may not bath until the sutures are out). Use a gentle soap and pat dry the incision. Do not apply any lotions, antibiotic ointments, or deodorant to the incision while it is healing. You may keep a clean, dry gauze dressing on the incision until you are seen in the office. Change the dressing as needed.
3. You should call the doctor if you have a fever greater than 101.0, redness along the incision, or drainage from the incision area.
4. You will be given a prescription for pain medication prior to being discharged from the hospital. Please have this filled on the way home from the hospital. Take the medication as needed for pain. If you feel the prescribed medicine is too strong for your needs you may take Tylenol instead, or Advil if your stomach can tolerate it.
5. Resume your normal activities as tolerated.
6. During the first week or so at home, you may expect to have some incisional tenderness and mild swelling of the area. This is normal. You may also notice that under the incision the breast tissue is firm or hard. This is also normal and will subside within 1-3 months.
7. Please call the Rowan Breast Center at 215-662-7900 to schedule an appointment for 7-10 days following the date of your surgery. If you have any difficulty scheduling the appointment please contact your surgeons office.