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Breast Clinic - FAQs

Q: What is breast core biopsy?

A: A breast core biopsy is a small sample of tissue taken from an area of concern within the breast and sent to a laboratory for testing. It is performed using ultrasound or mammographic guidance.
Q: What happens during a breast core biopsy?

A: Local anaesthetic is given. A small cut is made in the skin and the biopsy needle is inserted. Several samples may be taken. The procedure may feel uncomfortable but is not usually painful.

In some situations, after the samples have been taken a small titanium marker may be inserted into the breast via the biopsy needle. This is so the area of abnormality can be identified at a later date if surgery is required. If inserted, the biopsy marker is safe, cannot be felt and does not need to be removed.
Q: How long does a breast biopsy take?

A: An ultrasound guided core biopsy may take only 20 minutes. A mammographic guided core biopsy, also called a stereotactic biopsy, may take up to one hour, most of which involves positioning and taking images. Taking of the actual samples is very quick.
Q: What are the benefits of a breast core biopsy?

A: The core biopsy can take samples from an area of concern so that a pathologist can examine it and make a diagnosis. Accurate information can thus be obtained without the need for an operation to surgically remove the tissue for testing. A core biopsy may avoid unnecessary surgery of benign lesions. If surgery is required a biopsy can provide you and your surgeon with more information for surgical management and treatment.
Q: What are the risks of a breast biopsy?

A: You will usually have some bruising at the biopsy site. Occasionally a larger bleed may occur which results in more significant bruising with a lump that may take 6-8 weeks to disappear. There is a very small risk of infection which may not become evident until several days later.

A breast biopsy, especially if the lesion is located deep within the breast, carries a slight risk of the needle passing through the chest wall into the lung and possibly causing a slow collapse of the lung. This rare complication is called a pneumothorax and may need further medical treatment.
Q: Who does the breast core biopsy?

A: The breast biopsy will be performed by a trained Clinic Doctor and a Radiographer or Sonographer.
Q: When can I expect the results of my breast core biopsy?

A: Within 24 to 48 hours. The breast physician will arrange a means of providing you with your results.
Q: Do breast implants alter the risk of breast cancer?

A: No. Women with implants have the same risk of developing breast cancer as those without implants – a lifetime risk of 1 in 12.
Q: If I have an implant, what can I do about detecting breast cancer?

A: A screening mammogram is the single most effective means of detecting breast cancer at an early stage.

For women with implants there are special techniques to maximise the amount of tissue imaged.

Mammography is not designed for assessing an implant itself, and breast MRI may be necessary for women with a suspected implant problem.
Q: What are the limitations of mammography with implants?

A: Implants may make detection of small breast cancers more difficult. It is not possible to gain an x-ray image of all the breast tissue as some tissue may be concealed by the implant. The amount of tissue imaged will depend on how far the breast tissue can be drawn away from the implant.

Mammography may be technically more difficult if the capsule around the implant is tight.
Q: What are the risks of mammography with implants?

A: The body’s normal reaction to an implant is to form a fibrous capsule around it. This capsule may tighten over time. If it does tighten, there is a small risk that compression during mammography may tear the capsule. The compression is highly unlikely to damage the implant itself.

If there is undetected deterioration of the implant envelope, compression may cause silicone to be pushed out of the implant. However, this is a rare occurrence, and can also happen spontaneously, unrelated to a mammogram. The silicone is usually held in place by the surrounding tissue.

If you have any concerns, discuss them with the doctor or clinic staff before you have your mammogram.

Ultrasound

Ultrasound imaging uses sound waves, by passing a flat probe across the breast. Compression is not necessary. Ultrasound provides further diagnostic information if an abnormality is noted during mammography or physical examination.

Ultrasound is useful for women in whom mammography is unsuitable. Ultrasound is not as effective as mammography in screening for some types of breast cancer. It does not detect the specific kinds of early breast cancer which can only be seen with mammography.

For most women, both mammography and ultrasound are necessary. Neither mammography nor ultrasound will detect all types of breast cancer.

Ultrasound may show the presence of a leak of silicone from an implant within the breast, but will not provide information about the condition of the implant envelope.

Breast self-examination

If you notice any changes in your breast, discuss them with your doctor or clinic staff where you have your mammogram.

Cysts

Cysts are collections of fluids which occur in breast tissue. Approximately 60% of women will have at least one cyst during their lifetime. They are usually small and do not cause problems, but may increase in size, form a lump, or cause pain or tenderness.

Cysts occur most commonly between the ages of 35 and 50 years, They are uncommon after menopause except in women on Hormone Replacement Therapy, but can occur in women of all ages. They do not require treatment unless causing symptoms. Cysts can be emptied by withdrawing fluid through a needle.

Fibroadenomas

Fibroadenomas are very common nodules in the breast and are benign. They are common in young women (under 25) they appear as oval, tender, slippery masses, but they can occur at any age and may not be able to be felt as lumps. Many women have more than one.

Diagnosis is usually by ultrasound, needle sampling and mammography (in older women). Treatment is not essential but they can be removed surgically.

Fibroadenomas are not related to breast cancer but do need to be accurately diagnosed. This can usually be done by needle sampling.

Nipple discharge

Most nipple discharges are completely harmless when green, brown, straw coloured, milky or black – particularly if the discharge comes from more than one duct and from both nipples. These discharges are due to the production of fluid by normal breast cells in response to hormones.

However, if the discharge is blood stained or completely watery it is important to see your doctor and be investigated as surgery may be required.

Hormonal thickening

This is the most common change in the breast and can occur at any age during the reproductive years. It is the response to hormones and is often related to pre-menopausal breast tenderness. It may occur anywhere in the breast but is most common in the upper outer region of the breast, and may come and go.

Diagnosis is usually made with a combination of breast examination, mammography and ultrasound. No treatment is necessary unless breast pain or tenderness is troublesome.

Hormonal thickening is not related to the development of breast cancer. It usually disappears naturally after menopause.