Ultrasound Guided Breast Biopsy

An ultrasound view of a breast

An ultrasound-guided breast biopsy uses ultrasound imaging to help guide the radiologist’s instruments to the site of the abnormal growth.

An ultrasound uses sonic pulses to create images, rather than relying on low-dose radiation (as in a stereotactic biopsy) to do the same.

Your doctor may order a breast biopsy if she cannot determine whether a growth is benign or cancerous from imaging studies alone. The purpose of the biopsy is to determine a diagnosis by removing some cells and examining them under a microscope.

Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt by hand (called palpation), which makes the growth difficult to locate. With the help of an ultrasound, your doctor will be better able to locate the lesion, thus ensuring the accuracy of the test.  

What to Expect

How is a fine-needle aspiration done?

Your doctor will wipe the area with rubbing alcohol or iodine. In most cases, you will receive an injection of local anesthetic to numb the area of your breast where the needle will be inserted. Your doctor will hold the lump steady with one hand and insert a thin needle (attached to a syringe) into the lump. He or she may move the needle in and out of the area to make sure to get enough tissue or fluid for the biopsy. Then he or she pulls on the plunger of the syringe to remove the tissue or fluid. The process takes a few seconds to a few minutes.

If the doctor cannot easily feel the mass, you may have an imaging test, such as a CT scan, ultrasound test, magnetic resonance imaging (MRI), or mammography to see where to put the needle. If the lump is a cyst, the fluid is removed, and the lump usually goes away.

How will it feel?

If you receive a local anesthetic, you may feel a brief sting when it is injected. You also may feel some pressure when the biopsy needle is inserted. The amount of discomfort will depend on how much pain you feel from needles, the part of your body involved, and the skill of the doctor. The site of the fine-needle aspiration may be sore for a couple of days, and you may have a bruise. You should be able to return to work the same day or the next day.

What happens afterward?

Your doctor will apply pressure to the aspiration site to prevent bleeding and put an adhesive bandage on it. He or she may recommend that you take a mild pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil), if you have discomfort when you get home. Keep the area dry for 24 hours.

Contact your doctor if you have bleeding, redness, swelling, or a fever of more than 100.5F over the next couple of days

How to Prepare

Abdomen Ultrasound Preparation: Nothing to eat, drink, or smoke 6 hours prior to appointment time. Medications may be taken with a small amount of water.  

OB Less than 14 weeks and Pelvic Ultrasound Preparation: 1½ hours before exam time, empty your bladder and drink 32 oz. of water, finishing 1 hour prior to exam. Arrive with a very full bladder. Do not urinate. Pelvic ultrasound should not be scheduled during menstruation.

Equipment Used for This Procedure

Siemens Acuson S2000 Ultrasound

The Siemens Acuson S2000 Ultrasound machine can be used for many medical purposes, most notably for OB-GYN, Abdominal, and Vascular purposes. Ultrasound machines provide real-time visualizations of the inner workings of the body by using sonar. This machine has Contrast Enhanced Ultrasound Technology, which allows for much greater detail and clarity in the images it produces. Better images provide a more accurate diagnosis.