You have just finished your annual mammogram, but this time, something doesn’t feel right. A few minutes ago, the technologist asked you to get dressed and sit in this little room by yourself. The radiologist wants to speak with you, she said. In all the years you’ve been coming here, you’ve never spoken with the radiologist before. As you look at the walls, your mind begins to fill with questions: What did they see on the pictures? Is this the moment when everything changes? Will you be able to make it to your son’s graduation, your daughter’s wedding, the birth of your first grandchild?
When the radiologist finally arrives, she tells you that she notices something new on your mammogram. She emphasizes that you shouldn’t jump to conclusions, but that you need to have a biopsy to make sure everything is okay. You barely hear anything else she says and as you walk to your car, your mind swirls with confusion. You have no idea how you are going to drive home, much less wait three days until the biopsy is performed, then several more for the results.
This sense of disorientation and panic are quite common for those who are awaiting a biopsy and its results. As a radiologist specializing in breast imaging, I see this reaction every day.
If you’ve landed here because your mind is full of questions as you await a biopsy and its results, I thought it would be helpful to arm you with information. And remember: worrying will not improve anything, including test results. I try to emphasize to my patients the importance of remaining calm for their sake and the sake of their loved ones.
What is a breast biopsy?
This may be your first question upon receiving the radiologist’s recommendation You’ve heard the term, but you may not be sure exactly what it means.
A breast biopsy entails removing small pieces of breast tissue from the area that is showing up on your imaging in order to test the tissue in the pathology lab. Today, this procedure is usually performed with a needle designed to remove pieces of tissue (core needle). This is called percutaneous needle biopsy and is most often performed by your friendly radiologist (that’s me). The radiologist uses imaging—mammography, ultrasound, or MRI—to guide the needle right to the spot and take tissue from that area.
Why do I need it?
A biopsy has been recommended because the radiologist sees something on either your mammogram or ultrasound that requires further exploration. Sometimes, these imaging tests allow the radiologist to make a definite diagnosis such as a cyst or benign calcifications. However, occasionally the pictures are inconclusive and the extra step of a biopsy is required to help figure out the diagnosis and exclude cancer. A biopsy has been recommended because the radiologist sees something on either your mammogram or ultrasound that requires further exploration.
Will the biopsy hurt?
No one likes pain and needles are a common phobia. I can’t promise you won’t feel anything, but we try to make the procedure as painless and swift as possible.
The biopsy is usually performed with a local anesthetic to numb the part of your breast we are testing. The medicine pinches and burns as it goes in, sort of like a bee sting or Novocain at the dentist, but after that the area should be nice and numb. Some women say they do feel pressure or pulling and tugging during the biopsy while others feel nothing.
Is a breast biopsy a commonly recommended procedure?
Yes, very common.
Of 1000 women who get a screening mammogram, 100 (10%) 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.
What’s the chance I have cancer?
Of these 20 women recommended for biopsy, approximately 5 will be diagnosed with cancers. In other words, only about 25-30% of breast biopsies result in a cancer diagnosis and the remainder yield benign results including benign tumors like fibroadenoma and fibrocystic changes, a benign change in the breast tissue, to name a few. Just because a biopsy has been recommended does not mean cancer is a foregone conclusion.
How long will it take to get the results?
Believe me, we know you will be on pins and needles until you get the results, so we try to deliver the results as quickly as we are able. But we also want to make sure we give the pathologist—the doctor who analyzes the tissue and gives us the answer—time to do her job well. The time frame can vary, so be sure to ask the doctor performing your biopsy when you should expect the results and how you will be notified.
What do I do until I get the answer?
Try your best to go about your normal routine. Obsessing about the possible results isn’t helpful. Googling breast cancer or asking friends for referrals to oncologists will elevate your anxiety for no reason. Most of the time, your results will come back normal, and if they don’t, your doctors will provide you with the information you need to get the appropriate treatment. Congratulate yourself on seeking information that will allow you to live your best and most healthful life.
Heather Frimmer, M.D. is a radiologist specializing in breast imaging. She finds her therapy in writing fiction and will release her first novel, Bedside Manners, in October 2018. Follow her on all social media platforms @HeatherFrimmer.
