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During a self-exam, I found a lump in my breast. A mammogram and a sonogram also detected the lump, so my doctor and I decided that I should have a biopsy performed. What can I expect when I go in for the procedure?
March 27, 2000 (San Francisco, Calif.) -- When you go in for the procedure, your doctor will surgically remove the lump and perhaps a small amount of surrounding tissue. The removed tissue is then sent to a laboratory for analysis. Breast biopsies can help your doctor determine whether or not a lump is cancerous or non-cancerous. The vast majority of breast lumps -- about 80% -- are non-cancerous. Nevertheless, early detection of breast cancer can save lives, so the sooner a lump is evaluated, the better.
Breast biopsies are fairly simple procedures that are usually performed on an outpatient basis (meaning you don't need to stay in the hospital afterward) and with local anesthesia, so that you are conscious while only the specific area is numbed. Depending on the size and nature of your lump, your physician may recommend a general anesthetic, so that you will be unconscious, instead of a local anesthetic. You may also receive some sedative medication, which will relax you. It's a good idea to determine with your physician what type of anesthetic is best for you prior to surgery.
If you're planning to have your procedure in a hospital, you'll probably need to pre-register at the hospital a few days before your biopsy. You'll also need to arrange for someone to drive you to the hospital and back. For safety reasons, many hospitals do not allow patients to leave unaccompanied, even in a taxi, after surgical procedures.
When you check in at the hospital on the day of your surgery, staff members will review your personal and insurance information. A nurse will then take your vital signs, help you change into a hospital gown, and ask you to sign an operative permit, or permission slip. Most surgical permission slips identify the procedure to be performed in medical terms that may be unfamiliar or confusing. Be sure that the permit is correct and includes your name, the name of the procedure, and the breast (right or left) that is to undergo the biopsy. If you don't understand what your permit says, ask a qualified person at the hospital to clarify. It's a good idea to thoroughly discuss the permit, the procedure, and any possible complications with your doctor prior to the day of your surgery. But if you have any last-minute questions whatsoever, ask them before you receive any anesthetic medications or sedatives.
Once you're in the operating room, you'll probably receive an intravenous drip (IV) to provide needed fluids while you're not eating and drinking. IVs also enable your surgeon, or the assisting anesthesiologist (a specialist in anesthesia) to administer anesthetics or sedatives. After the surgeon is sure you're comfortable and the biopsy site is fully anesthetized, he will make a small incision and remove the lump and possibly some surrounding tissue. Once the lump is removed, some doctors use a cautery apparatus: an instrument that uses heat, cold, or chemicals to fuse tissues together and minimize bleeding. After the procedure, your surgeon will close the biopsy site with sutures, then place a bandage over the area. The biopsy site should be fully healed within a few weeks, usually leaving a small scar. Your physician will let you know when you may return to normal activities and when the stitches need to be removed.
You should be able to leave the hospital within an hour or two of the procedure. Depending on the extent of surgery, your physician may prescribe an over-the-counter pain reliever, such as Tylenol or Advil, or stronger medications that include codeine or other narcotic pain relievers. It's a good idea to have any prescriptions filled before your surgery, so you'll have less to worry about during your recovery.
Although your physician may have some idea of the nature of your lump from viewing it during surgery, all removed tissues are sent to the laboratory for microscopic evaluation. The lab results should come back in two to three days, at which point your doctor will plan to meet with you, or call you to discuss the findings. If the lump is malignant, he will talk to you about treatment options. If the lump is benign, you probably won't require any further medical attention. Just be sure to maintain regular checkups, self-exams, and breast cancer screenings.
Laurie Green is a founding partner of the Pacific Women's Obstetrics and Gynecology Medical Group. She is a clinical instructor at the department of obstetrics and gynecology at the University of California, San Francisco, and has appeared on many television shows advocating women's health.
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