A biopsy is a short procedure during which a doctor takes a small sample of cells from the breast. A pathologist examines the tissue sample under a microscope and determines whether the cells are normal or cancerous.

We use the least invasive biopsy procedure possible, minimizing discomfort while still obtaining enough cells to make a diagnosis.

We specialize in image-guided biopsy, which uses one of our imaging technologies to precisely locate the area where we need to take the tissue sample. We offer several types of breast biopsy, and you may need one or more types depending on your individual case.

• Needle biopsy: The doctor inserts a needle into the breast to remove a tiny sample of cells from a suspicious area. There are 2 types:
  • Fine-needle aspiration biopsy uses a very thin needle and syringe. You may or may not need a local anesthetic (numbing medicine) for this procedure.
  • Core biopsy uses a wider needle to take the sample. Your doctor will give you a local anesthetic to numb your breast for the procedure. This is the biopsy procedure we use most often to confirm a diagnosis of breast cancer.
• Image-guided biopsy: Our radiologists often use imaging to precisely locate the abnormal tissue and guide the needle for the sample. Types of imaging for guided biopsy include:
  • MRI-guided breast biopsy using radio waves and a magnetic field
  • Ultrasound-guided biopsy using high-frequency sound waves
  • Stereotactic-guided biopsy using mammography
• Surgical biopsy: In rare situations, a surgeon may remove part of a tumor for testing, or all of it. The goal is to determine whether the tumor is benign (noncancerous) or malignant (cancerous).

Pathology: Analyzing breast biopsies

After you have a biopsy, your nurse sends your tissue samples to our pathologists for review. A pathologist is a medical doctor who specializes in reviewing and evaluating lab tests, cells, and tissues to diagnose disease. Our pathologists analyze biopsy samples to determine whether the tissue is cancerous and, if so, what type of breast cancer it is.

At the Stanford Breast Cancer Program, all of our pathologists specialize in breast cancer. That focus means they have extensive expertise interpreting breast biopsies and other tests to confirm or rule out a breast cancer diagnosis.

Because breast cancer represents a complex group of different diseases, it’s important to have expert pathologists on your care team. Years of experience studying breast cancer every day means your pathologist can accurately identify critical details. This information includes whether the cancer:

• Is invasive or noninvasive
• Shows a high or low cell grade (rating that describes how different the cancer cells are from normal cells)
• Is aggressive or slow growing
• Contains molecules that indicate the cancer subtype

All these details help form an accurate diagnosis, which is vital to your treatment plan. Your care team takes the time to do a thorough evaluation from the start, so that your treatment will be more effective.

Breast tumor tissue bank

Our doctors and researchers work to thoroughly understand the true diversity of breast cancer and identify the genetic abnormalities that can play a role in breast cancer formation. That’s why it’s critical that our doctors have access to tissue samples to plan for each patient’s care.

At Stanford, we store breast tissue samples so we can use them for research, using the following process:

1. After we take a biopsy (tiny sample of breast tissue), we ask you if you would like to give it to the tissue bank.
2. The tissue first goes to the laboratory, where the pathologist samples it.
3. If you approve, the tissue then goes to breast cancer research specialists. These doctors work with our clinicians (doctors involved in patient care) to identify new pathways of tumor formation and possible treatments.
4. The data is made anonymous and is not available to you after donation, because we use it for research and not for clinical use in making treatment decisions.

Our breast tumor bank provides our doctors and other researchers with a variety of different types of breast cancer cells to study. As we work on new methods and tools for diagnosing and treating breast cancer, our goal is to move these findings from the lab into patient care.

Published April 2018

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