Breast needle biopsy: what happens next?

You have been given this leaflet because you have recently had a breast needle biopsy. The purpose of this leaflet is to inform you about what to do with your dressing and the possible outcomes once the results of the biopsy are known.

How do I manage the wound dressing and potential after effects?

Wound dressing: Ideally you should keep the top gauze dressing dry. It can be removed after 24 hours. It is safe to shower and bath with the skin closures which you should keep in place for a further three or four days.

There are sometimes complications/ after-effects following a breast needle biopsy procedure, including the following:

Bruising: You may have some bruising and swelling after the biopsy. This is normal but very variable. If the wound starts to bleed again apply firm pressure for at least five minutes.

Pain: You may feel some discomfort after the biopsy. If this happens do take a mild pain killer such as paracetamol (Panadol). Avoid aspirin as this could encourage bleeding.

The lump: Needle biopsy is a very safe technique and will not disturb or spread cells. Sometimes the bruising around the site might make you feel the lump has increased in size but please be reassured this will subside as the bruise settles.

If you are worried, you are welcome to contact the breast care nurse specialist on the numbers you were given on their card.

When will I get the results of the biopsy?

Your samples will be sent to the histology laboratory for processing. This can take up to 10 days before we have the results. When they are ready the whole team will discuss all the information and decide any next steps, if needed.

Before you leave the clinic an appointment will be made to give you the results of your biopsy. This can be either a telephone appointment or a face‑to‑face meeting.

What are the possible outcomes?

There are a number of possible outcomes of the biopsy, some of which are listed below. The team who performed the biopsy will have explained what they think is most likely before you go home. You should have been able to discuss any questions or concerns. The final answer will not be available until the specimen has been examined in the laboratory.

1. No further action

About two out of three needle biopsies are no cause for concern (we use the terms ‘innocent’ and ‘benign’).

The most likely cause is a fibroadenoma and if the team think this is likely to be the case, we will give you a leaflet explaining what a fibroadenoma is before leaving the clinic.

2. Further biopsy is required

Very occasionally, we do not obtain enough tissue or the answer from pathology does not match the findings then we might need another biopsy or more imaging.

About one in 30 needle biopsies are ‘indeterminate’ or more accurately called ‘lesions of uncertain malignant potential’. This is an assortment of relatively rare lesions including, among other things, papilloma, radial scar, fibroepithelial lesion and atypias. (Atypia is when cells lining the ducts or lobules in the breast increase in number and develop an unusual pattern or shape. ‘Atypical’ means ‘not typical’.)

These are not cancers, but they may indicate cancer in nearby cells that we have not sampled, or they might increase your risk of developing cancer in the future.

In this situation, we would usually like to obtain more tissue because occasionally we find more atypical cells and, sometimes, a cancer. In the past, we used to offer to remove the area with a surgical operation that requires a general anaesthetic and a day in hospital.

Now, for most of these lesions, we can obtain the same results using a vacuum needle, in the clinic, under local anaesthetic. There are, however, still some lesions that we would prefer to remove by a surgical operation, which would require a general anaesthetic.

Each of these lesions is different; we will discuss your options in detail with you.

If no cancer is found on your second sample, then we will either discharge you or offer you more regular mammography.

3. Treatment is required and/or further investigations

About one in three needle biopsies confirm cancer.

We now know that breast cancer is not one single disease. Some are very slow growing cancers that might not cause you any harm even if not treated. On the other hand, some can grow and spread quickly.

We treat each cancer individually. If you do have a breast cancer, we will explain all your options in some detail at your result clinic and will help you make the best decisions about your treatment. This may include surgery, radiotherapy or chemotherapy.

There are many ongoing clinical trials investigating the numerous types of breast cancer. If there is a trial specifically designed for your identified type of cancer you may be invited to take part in that trial. All patients who take part in these trials help us to improve treatment for other women in the future. Taking part in clinical trials is optional, but not joining a trial, if offered, will not affect the level of clinical care given.