Open Breast Biopsy
Ultrasound-guided breast biopsies are the gold standard for assessing unusual breast changes, but results can occasionally be uncertain with these techniques. When that happens, an open breast biopsy is needed.
Dr. Ebanks has undergone extensive training and has years of experience performing open breast biopsies. At Cayman Islands Surgery Center, our multidisciplinary team and wide referral network have helped countless patients in Cayman get safe and accurate breast biopsy testing.
What Is an Open Breast Biopsy?
An open breast biopsy is a surgery to remove abnormal breast tissue to test for cancer. During this procedure, a doctor makes an incision and removes all or part of the abnormal tissue, which is sent to a laboratory. A pathologist then examines this tissue under a microscope to see if it contains any cancer cells.
An open biopsy is usually only performed when test results from an ultrasound-guided biopsy or stereotactic biopsy fail to provide a clear answer. That is because an open biopsy is more invasive and thus comes with more risks and complications. However, a skilled surgeon can minimize risks and complications even with open surgeries.
Both procedures are usually performed in a clinic’s outpatient department. Patients are typically put under general anesthesia or are given regional anesthesia and IV sedation, meaning only the area being treated is numbed, and you are awake (but relaxed) during the entire procedure. However for more complex surgeries patients may need to stay in the hospital overnight.
There are two types of open breast biopsies:
- Incisional biopsy - Only part of the abnormal tissue is removed
- Excisional biopsy - The entire tumor or abnormal area is removed along with a margin of normal tissue
When the lump or abnormal area is particularly small or hard to locate, doctors rely on wire localization to locate the abnormal area for surgical removal. Dr. Ebanksa or radiologists perform wire localization on the same day of the biopsy procedure. This is done under local anesthesia and involves placing a hooked wire inside the abnormal tissue using image guidance and a hollow needle. Newer methods involving detectable sonographic clips are also used for easier localization of tumors. These may be left in place after an incisional biopsy in case surgeons need to operate in the same area again.
- Disclose to their doctor what medications they’re taking, including over-the-counter medications and supplements. Some medications are unsafe to take when undergoing surgical operations.
- Disclose if you have any allergies, especially to anesthetics. Some patients may have dangerous allergic reactions to anesthetics, which can be prevented.
- Stop taking blood-thinning medications, including aspirin, for a recommended period prior to your surgery.
- Have someone ready to drive you home. The anesthetic and sedatives used during an open biopsy can make you feel drowsy afterward, which will impair your ability to drive.
- Plan to take at least some time off work and avoid strenuous physical activity.
- Give our clinic your advance care plan if you have one.
The treatment area will feel sore for a couple of days after the procedure. You can help control this by wearing a comfortable bra, taking over-the-counter pain medication and resting.
Do I Need an Open Breast Biopsy?
Doctors refer patients to biopsies after other forms of cancer screening detect abnormal breast changes. Your doctor may suggest a biopsy if:
- You notice a lump or unusual thickening in the breast after a self-exam
- A health care provider notices a lump, abnormal skin changes or abnormal nipple discharge
- Your routine screening mammogram shows a suspicious area in the breast
- An ultrasound scan or MRI shows unusual breast changes
Most patients (over 99 percent) believed to be at risk for breast cancer first undergo less invasive procedures like a stereotactic or ultrasound-guided biopsy. These tests are generally highly accurate and come with few risks, but they occasionally fail to provide accurate results. An open biopsy can help clear any doubts regarding your diagnosis.
Make an Appointment at Cayman Islands Surgery Center
If you’re concerned about a new lump in your breast or your last biopsy results weren’t clear, make an appointment with Dr. Tanja Ebanks for evaluation. Dr. Ebanks is a general surgeon who specializes in various forms of breast surgery, including open breast biopsy. She will carefully assess your condition and find the best treatment options for you.
Can you work after a breast biopsy?
Most patients can resume work the next day after an open breast biopsy, but this largely depends on the nature of their work. If your work involves lifting anything heavy, it’s a good idea to take at least a couple of days off to minimize the risk of bleeding, infections and other complications.
How long is the recovery from a lumpectomy?
Breast biopsies typically do not cause breast cancer to spread. When cancer is highly suspected a larger margin may be aimed for when performing an open biopsy, reducing the risk of the cancer to spread. In fact, patients have a greater probability of survival if they undergo a biopsy.
Can a breast biopsy remove cancer?
Yes, a breast biopsy may occasionally remove cancer, a so called upgrade. However, you may still need to undergo a sampling of the margins, sentinel-node biopsy or receive radiation therapy to ensure complete cancer treatment and to help prevent the cancer from recurring.
Who can perform a breast biopsy?
A general surgeon usually performs open breast biopsy procedures. The excised tissue is then examined by pathologists in a laboratory. Your surgeon is the person who will inform you about the results of your biopsy.
Will a breast biopsy leave a scar?
An open breast biopsy will leave a visible scar. However, skilled surgeons aim to make the scar as discreet as possible. Dr. Ebanks uses careful surgical techniques and stitching to minimize scarring. She will also explain how to dress your wound and what to do after your surgery to help the wound heal well.
What anesthesia is used for a breast biopsy?
Patients can be given local or general anesthesia for a breast biopsy. For regional anesthesia, you are given Lidocaine injections and similar anesthetics and possibly sedatives to help you relax. For general anesthesia, you are given IV drugs like Propofol that keep you unconscious during the procedure. You will have enough time to discuss the most preferred and suitable option for you with Dr. Ebanks and the anesthesiologist.