The two most common reasons for breast biopsies are a palpable mass in the breast and a suspicious finding on mammogram. A palpable mass that is felt in the breast can be evaluated in several ways depending on the recommendations of your doctor. If a lesion is thought to be fluid filled (cystic) a fine needle aspirate (FNA) is often the 1st step. If the cyst contains cancer a FNA will detect this greater than 90% of the time. If a mammogram is suspicious for tumor the surgeon or radiologist will usually proceed to a biopsy.
Lesions that can be felt have historically been removed using surgical excision. However, less invasive image guided biopsies are more frequently done today. These biopsies can be performed with the aide of stereotactic (x-ray), ultrasound or MRI guidance. Up to 80% of non-palpable mammographic abnormalities can undergo stereotactic biopsy. The advantage of image-guided biopsy is it is a quicker, less invasive and a less expensive way to diagnosis breast cancer.
In addition, numerous studies have shown the procedure to be statistically equivalent to surgical biopsy. The false negative rate of stereotactic biopsy is considered less than 2%, which is similar to open biopsy.