Getting any sort of health-related testing can be nerve-wracking: Odds are that you're fine, but you know there's always a chance of getting bad news. Sometimes, though, the results aren't straightforward. In other words, you might get a call letting you know you need further testing.
This is especially common after a mammogram, when many people are told they need to have a breast biopsy. Yes, it can be scary, but it doesn't necessarily mean you have cancer. We spoke with Dr. Heather Frimmer, a radiologist specializing in breast imaging, about what you should know if you're told you need a breast biopsy.
Why would you need a breast biopsy?
When you go in for your annual mammogram, your radiologist may notice that something new has appeared in the images since your last mammogram. (This is why it can be helpful to get a baseline mammogram and continue to get mammograms regularly — so the radiologist has something to compare the new images to.) If this happens, they'll likely request you get additional mammogram images or an ultrasound to get a better look at the changes.
"Sometimes, these imaging tests allow the radiologist to make a definite diagnosis, such as cyst or benign calcifications," Frimmer tells SheKnows. "However, occasionally, the pictures are inconclusive and the extra step of a biopsy is required to help figure out the diagnosis and exclude cancer."
What happens during a breast biopsy?
Most breast biopsies today are not the same invasive surgical procedures they were in the past. Some people don't know this, so in addition to being worried about the results, they are nervous about the procedure itself.
In reality, it's relatively simple now, Frimmer explains. Whereas the older surgical version of a breast biopsy could require general anesthesia, the type common today only uses a local anesthetic — like lidocaine — to numb the area. According to Frimmer, the possible pain and burning from the anesthetic is typically the most uncomfortable part of the procedure.
Then, through image guidance, the radiologist inserts a thin needle into the breast to remove a small piece of tissue. The whole procedure should take around 10 minutes, Frimmer says.
The removed tissue is then sent to a pathologist, who looks at it under a microscope and gives the radiologist more information about what's causing the abnormality, she adds.
How common are breast biopsies?
Of course, you never want to hear your radiologist tell you something popped up on your mammogram, but hopefully, it'll help to know that being called back for a breast biopsy is pretty common. According to Frimmer, out of 1,000 women who get a screening mammogram, 100 (10 percent) will be called back for more pictures, either additional mammogram pictures or ultrasound; of those 100 women who are called back, a biopsy is recommended for 20 of them.
How long will it take to get the results?
Unfortunately, breast biopsies aren't instant. Frimmer explains this is because the radiologist and pathologist want to make sure they take their time and make sure they understand as much as possible about what's happening with your body before giving you any news.
A lot depends on the institution where you got your mammogram and biopsy done. Some places have the facilities and personnel for a quick turnaround — like 24 hours, Frimmer says. Other places can take several days or a week to get the results. Frimmer recommends asking your doctor or radiologist how long you should expect to wait for the results to make that difficult time a little easier to manage.
Does this mean I have cancer?
Again, a breast biopsy is another type of test and doesn't automatically mean you have cancer, Frimmer says. In fact, a majority of breast cancer biopsies are benign and are primarily caused by benign tumors like fibroadenoma and fibrocystic changes, she explains.
However, according to Frimmer, 25 to 30 percent will result in a cancer diagnosis. In those cases, what happens next also depends on the institution. Someone from the hospital will call the patient and let them know cancer was found and what the next steps will be. The first thing to do, Frimmer says, is to schedule an appointment with a breast surgeon.
Many hospitals now have breast cancer navigators — nurses who help patients navigate the whole process and help them figure out who they need to see, answer any questions they may have, guide them in the right direction and provide emotional support for patients and their families.
What else should we know about breast biopsies?
The biggest thing Frimmer wants people to know is that breast biopsies are not unusual and shouldn't be cause for alarm.
“Don’t panic — this is very common,” she says. “A lot of women have biopsies. It’s really just an extra diagnostic test.”