Breast Biopsy

Question: A mammogram I had recently showed a suspicious mass at 9 o’clock on my left breast. I went for the mammogram because I felt it. I had a biopsy, which was negative. I am uncomfortable with the negative diagnosis. What can I do?

Answer: Thank you for contacting Ask a Breast Imaging Expert. It is your right to get a second opinion from a different hospital or different doctor. Check with your insurance provider about their rules for getting second opinions. It is possible that the new doctor would want to look at the slides from your first biopsy, or may want to do a repeat biopsy. Biopsies can be done with different size needles, and if what you had before was an FNA (fine needle aspiration), it may be that you would need a core biopsy. X-ray assisted biopsies (called stereotactic) help the doctors get to exactly the right spot. MRI and ultrasound can also be used to localize the biopsy site. Keep in mind, though, that most breast biopsies do turn out to be “benign”, or a disease that is not a cancer, such as a cyst. Doctors at one of the Memorial Hermann Breast Centers (713-512-6040) or at the LBJ General Hospital (713-526-4243) can help guide you to doctors that can give you a second opinion.

Question: Why do I have to have a biopsy if the mammogram says I have cancer. Can’t they just take out the lump in surgery?

Answer: Thank you for contacting Ask a Breast Imaging Expert. Although a mammogram and ultrasound can tell your doctor when a lump or cluster of calcifications looks suspicious for cancer, a diagnosis is only made with a biopsy, and not with any imaging procedure. Actually, 4 out of 5 suspicious spots seen during imaging turn out NOT to be cancer after biopsy. Open surgical biopsies (that take out the lump) are sometimes performed, but they are costly,require general anesthesia, and sometimes cause scar tissue that can make future mammograms more difficult. Needle biopsies generally do not leave a scar, can be done with local anesthesia and you will have only a short recovery time. Breast cancer can be made up of different kinds of cancer cells with different rates of growth. If positive, the biopsy results will give your doctor information about the type of cells and to which treatments these cells might respond. The radiologists at Memorial Hermann Breast Centers (713-512-6040) or at the LBJ General Hospital (713-526-4243) work closely with the doctors who will treat cancer, and can perform the biopsy your doctor recommends. We wish you well, and advise you not to wait very long to have your biopsy.

Question: I had a biopsy and there is no cancer. I need the titanium clip removed due to side effects. My OBGYN sent me to a surgeon who suggests a major surgical procedure! However, I’ve read that the clip can be removed as an outpatient using the same stereotactic biopsy device (used to perform my biopsy) targeting the marker as it it were a small group of calcifications. If a surgeon doesn’t know this, then what kind of Dr. do I contact specifically who can do this procedure? Does UT do this?

Answer: Yes. We can remove the clip using the same technique and equipment of biopsy targeting the clip. She will be billed for a stereotactic biopsy and we have to send the sample to pathology since some tissue will be removed with the clip.

Yes. We can perform the procedure at UTHealth/MHH. She needs an order from her doctor’s office for biopsy/clip removal and she can call 713-704-3494 for appointment at our breast center.