Open biopsies

An open biopsy is a way of checking the entire breast lump for cancerous cells, rather than just a part of it. 

Why an open biopsy?

Usually, a ‘triple test’ gives enough information for a specialist to be very confident that a breast change is not cancerous.

A triple test involves:

• a physical examination
• a mammogram or ultrasound
• a fine needle aspiration (FNA) or core biopsy.

99.5 per cent of cancers are diagnosed when all three of these tests are used.

Sometimes a specialist needs to do an extra test to be fully confident to diagnose a breast lump. This test is called an open biopsy.

It might be needed if:

• you have an increased risk of breast cancer
• you are over the average age for a common and not dangerous breast condition called fibroadenoma
• the lump is growing rapidly
• your specialist suspects the lump might be abnormal.

An open biopsy is a way of checking the whole lump for cancerous cells, rather than just a part of it. A core biopsy or FNA happens first, so that the specialist knows whether it is likely that the lump contains cancer.

What happens during an open biopsy?

You will have a general anaesthetic so that you are unconscious during the operation. The surgeon will remove all or part of the lump out of your breast and send it to the laboratory for testing. You will wake up after the lump has been taken out and the wound has been stitched. You will need to spend at least a few hours in hospital, but usually you do not have to stay overnight.

If your breast lump is not easily felt, its position in the breast might need to be marked with a fine piece of wire. This is done before the operation by a radiologist. Local anaesthetic is usually used to numb the skin. The wire is then inserted through a needle guided by a mammogram or ultrasound. The procedure is called a hook wire localisation. Some women may find it painful and unpleasant; most experience only a little discomfort. When the wire has been inserted, it will stick out through the skin from the lump. It will be removed with the lump during the open biopsy.

After the operation

The effects of the operation depend on the person, and on the size and location of the lump.

You might feel some pain or discomfort for up to a week.  Limiting activity, wearing a bra and taking mild pain relief will help. 

You will have stitches where the lump was removed. Ask your specialist about when and how the stitches will be removed. The wound will also be covered by a small dressing. This does not usually need to be changed and you can often wear it in the bath or shower. Ask your specialist about when you can take it off.

When the wound heals, you will have a scar. This will probably fade over time. Rubbing vitamin E oil or cream into the scar might make it softer. Sometimes scars continue to be sensitive or painful. If this happens, you should discuss it with your doctor. Biopsies and scars do not affect a woman’s ability to breastfeed.

Results of biopsies

Once the lump has been taken out, it will be sent to the laboratory. There, a pathologist will check the cells under a microscope.

It may take a week or two for your results to come through. You will need to return for another appointment to discuss the results of your biopsy with a specialist. 

Feelings before and after a biopsy

Women often worry that their breast change is cancer. Although the changes may be uncomfortable, painful or worrying to women, they are rarely cancer. There are many reasons for breast changes, and most are not dangerous or harmful.

Knowing that most breast changes are not cancerous might not stop the stress or worry. This is understandable. Different women have different ways of dealing with their feelings and you should do whatever is helpful for you.

A good first step might be to talk to a supportive family member or friend. You could also get information or advice from your GP or a Women’s Health Nurse at your local community health centre.

Things to remember

This sheet gives some general information for women who are having an open biopsy for a breast change.  Open biopsies differ for each woman. Also, each hospital has slightly different procedures and requirements.

You should discuss all aspects of the open biopsy with your doctor. Questions you might want to ask are:

• Where will the scar be?
• How big will the scar be?
• How much pain or discomfort might I feel afterwards?
• How long will it take to recover?
• When will I find out my results?

---

---