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Breast Biopsy
Questions about the definition, risks and results of breast biopsy.
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AskedPublicly Submitted Question
1/19/20181. Radiologist first recommended fine needle aspiration biopsy. I was not sure that I could tolerate even that much trauma. After phone consultation with my physician, they both "prefer" that I have core needle biopsy.

2. Besides size of needle, please explain what is the difference and what advantage(s) CNB has over FNA. I do not understand how the results are different or more definitive.

3 How are clips inserted through a needle? Are there potential side effects?

4. What are relative risks of bleeding and infection? What is extent of post-procedure bruising and discomfort? How long do they last?
RepliedJHU's Breast Center Reply
1/20/2018A core needle biopsy is taking a sampling of the actual tissue to send to pathology. FNA takes fluid and possibly very small bits of tissue that are able to pass through the needle. A core biopsy offers a more definitive diagnosis because there is a bigger sampling of tissue. If there were abnormal cells in the mass, but just so happen to not be at the place where the small FNA needle reaches, they could be missed. If you are extremely apprehensive, you can ask your doctor to prescribe an anti-anxiety medication to take before the procedure - many patients do this. Talk to them about this because you will need to sign consent paperwork before taking the medication.

The clip is very, very tiny and is loaded into the core needle instrument and left in place when the tissue is extracted. There are usually no side effects from that, and leaving the clip is a good thing because it marks the spot and will be seen on future breast imaging as a biopsy site.

As with any invasive procedure, there is a risk of bleeding and infection. Patients are instructed to stop aspirin and/or blood thinners about a week before the biopsy to reduce bleeding. Some women experience bruising and some do not, everyone is different. The discomfort and/or bruising usually last about a week or two.

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