Large Needle Core Biopsy

Large needle core biopsies are used to obtain tissue from a breast mass that can be felt by the doctor, or by the radiologist for smaller masses that cannot be felt, using ultrasound for guidance. The core needle removes a small cylinder of tissue about the size of a pencil lead (1/16th of an inch) and ½ inch long. Usually 3-5 tissue ‘cores’ are sent to the laboratory for the pathologist to examine. Providing a large amount of tissue for examination makes an accurate diagnosis easier. Final pathology reports are available within 3 business days. You will be notified of these results by Center for Breast Health staff. Your primary healthcare provider may also notify you of these results.

It is recommended that aspirin therapy and blood thinners, such as Coumadin and Plavix, be discontinued at least three days prior to this procedure to reduce complications from excessive bleeding. You should check with your healthcare provider who prescribed these medications before discontinuing them for this procedure. Other medications may be taken as prescribed.

During The Procedure

You will be asked to lie on your back on the examination table. Pillows will be used to make you comfortable and to allow the doctor easy access to the area of the breast to be biopsied.

Your skin will be thoroughly cleansed with an antiseptic solution. 

The area will be numbed with an injection of local anesthetic. Both the skin and deeper breast tissue will be injected with the anesthetic to assure your comfort during the procedure. Once the anesthetic has been injected, the doctor will wait a few minutes to allow the medication to take effect. If you feel any painful sensation in this area, be sure to let the doctor know. Additional anesthetic can be injected, if needed, to assure your comfort throughout the procedure.

Once the breast tissue is numb, a small incision (about 1/8th of an inch long) will be made in the skin to allow easy insertion of the core needle into the breast tissue.

The needle will be guided into the mass and the sample obtained. The device containing the core needle is spring loaded and will make a ‘snapping’ noise as the needle takes the sample.

After each tissue sample is obtained, the doctor will withdraw the needle and the core of tissue from your breast. The core is placed into a preservative solution and visually inspected by the doctor. The preservative will keep the sample in the best possible condition for examination by the pathologist. To minimize bleeding and bruising, a nurse/technologist will use a piece of gauze to hold firm pressure on the incision.

After The Procedure

Once the procedure is completed, you will be helped up to a sitting position and then off of the examination table. Because you have been required to lie in one position for a prolonged period, it may be difficult for you to get up unassisted.

You may apply ice to the biopsy site to relieve bruising and swelling. Do not apply the ice directly to your skin. Wrap the ice or ice pack, in a washcloth and do not use longer than 15 minutes, at each application, to avoid damage to the skin from frostbite. You may apply the ice pack every 1-2 hours, as needed.

If you notice excessive swelling, bruising, bleeding, redness and/or heat at your biopsy site, please call us at 563-421-7625, or call your primary healthcare provider.

You may use acetominophen (Tylenol) or ibuprofen (Advil, Motrin) every 4-6 hours as needed for pain. Do not use aspirin, or aspirin containing products, to reduce the risk of bleeding.

You may find it necessary to restrict your activity, use of your arm on the biopsy side, following the procedure. You may return to work and your usual activities when you feel you are able. If you will need a work release/excuse, please inform our staff prior to leaving the clinic.

If you are on Coumadin, Plavix or aspirin therapy, and these were temporarily discontinued for this procedure, you should call your healthcare provider who prescribed these medications for you for instructions on when to begin taking them again. 

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