Breast Biopsy

Breast Biopsy & Preoperative Localizations

To reach Sonnenalp Breast Imaging in Edwards, call (970) 569-7690.
To reach the Breast Imaging Clinic in Dillon, call (970) 668-6400. 

All types of biopsies are performed at Sonnenalp Breast Imaging in Edwards. 

Most dense breasts and abnormalities in the breast are detected by a physical breast exam, mammogram, breast ultrasound or breast MRI.  As it is not usually possible to tell from these tests whether an abnormality is benign or cancerous, a core biopsy is often recommended. A biopsy is a test that removes small tissue from the area in question to be reviewed by a pathologist under a microscope. There are different types of core biopsies, which are described below.

Magnetic Resonance Imaging (MRI) uses a strong magnetic field to produce images of the breast. The MRI biopsy is performed at Vail Health Hospital as an outpatient procedure. The patient can expect to be at the hospital for two hours. The technologist inserts an IV line into a vein in the patient’s arm or hand, and contrast material is injected. The patient lies face down with the affected breast gently compressed between two plates. A series of MRI images are taken, and computer software assists the breast radiologist in calculating where the area should be sampled.
The breast radiologist uses local anesthetic to numb the area to be sampled, and then a probe is inserted into the breast, which removes tissue from the abnormal area. A small inert titanium marker is left inside the breast to mark the area that was sampled. This marker causes no harm, nor does it set off any airport alarms. It is important to have the marker placed for future reference. A series of MRI images are taken to confirm the biopsy area. The technologist then cleans and dresses the area of the biopsy site, and the tissue is sent to the pathologist for analysis. The patient is given an ice pack, and Tylenol is recommended for any post-biopsy pain.MRI-guided biopsies are recommended for abnormalities such as:

  • A suspicious mass not seen on another breast imaging test
  • An area of distortion
  • An area of abnormal tissue change

Breast ultrasound is performed to localize the area of abnormality to be biopsied. Ultrasound uses sound waves to image the breast tissue. Ultrasound biopsy is performed as an outpatient procedure, and patients can expect to be at the Breast Center for 1 to 1½ hours. During the procedure, the patient lies on his/her back, and the sonographer locates the area to be biopsied by placing warm gel and an ultrasound transducer on the breast.
The radiologist then numbs the area with local anesthetic, and a probe is inserted into the breast, which removes some of the abnormal breast tissue. A small titanium marker is placed inside the breast to mark the area that is sampled. This marker is inert and causes no harm, nor does it set off any airport alarms. It is important to have the marker placed for future reference. After the biopsy is completed, a mammography technologist performs a mammogram and dresses the biopsy area. The breast tissue is sent to the pathologist for analysis. The patient is given an ice pack, and Tylenol is recommended for any post-biopsy pain.A breast ultrasound guided biopsy is recommended for abnormalities such as:

  • Suspicious solid masses
  • Distortion of breast tissue
  • Areas of abnormal change of tissue
  • Areas of abnormality corresponding to abnormal areas seen on a Breast MRI

A stereotactic breast biopsy is an outpatient procedure that uses a special X-ray machine to help guide the breast radiologist to the site of abnormality. The patient lies on the stomach and the breast falls through a hole in the table. The mammo technologist positions the patient and uses compression to immobilize the breast. Several images are taken to confirm the location of the site to be sampled. This is a sterile procedure performed using a local anesthetic.
A needle is inserted into the area to be sampled, and several core samples are taken.  A small titanium marker is left inside the breast to mark the area that is sampled. This marker causes no harm. It is important to have the marker placed for future reference. After the biopsy is completed, the technologist performs a mammogram and dresses the biopsy area. The tissue is then sent to a pathologist for analysis. The patient is given an ice pack, and Tylenol is recommended for any post-biopsy pain. Patients can expect to be at the Breast Center for about two hours for each site to be biopsied.Stereotactic breast biopsy is often recommended instead of a surgical breast biopsy because it is less invasive. Surgical breast biopsy is an operation performed in the hospital under general anesthesia.  During an excisional surgical breast biopsy, the surgeon attempts to completely remove the area of concern, often along with a surrounding margin of normal breast tissue.

Stereotactic biopsy is recommended for the following abnormalities:

  • Calcifications (please see the description of calcifications below)
  • A suspicious mass or other abnormalities not seen with breast ultrasound
  • Distortion of the breast
  • History of breast cancer to map out further treatment options

Calcifications are tiny deposits of calcium that may appear in breast tissue. They are seen best on mammography images and are divided into two types of calcifications: micro calcifications and macro calcifications. Macro calcifications are radiographically larger calcium deposits and are usually not linked to breast cancer. Micro calcifications are smaller, tightly grouped (clustered) calcifications, which can be associated with abnormal cell growth. Although 80 to 85 percent of micro calcifications are benign, they may be a sign of early breast cancer, known as ductal carcinoma in situ (DCIS).

Not all micro calcifications need to be biopsied. A breast radiologist may recommend that the patient return for a six-month follow-up diagnostic mammogram to check for stability or evaluate change.

Preoperative Savi Scout or MagSeed Guidance Localization

Preoperative Savi Scout or MagSeed Guidance Localization are usually performed after the patient has received a breast biopsy in which the results were indeterminate or positive. Our Multidisplinary Breast Health Team will decide and discuss with you which option is best for your care. The examinations are scheduled at the Breast Center prior to surgical breast biopsy. The method of localization depends on the core biopsy type that was performed initially, either stereotactically or under ultrasound. The procedure is performed under standard sterile conditions and typically takes about 1 to 1½ hours.

For Savi Scout or MagSeed® placement
The breast radiologist will numb the patient’s breast and insert a small a small clip that is placed under mammography, stereotactic guidance or ultrasound to guide surgeons during lumpectomy. A post procedure mammogram examination will be performed to confirm placement of the clip. The clip can be placed up to 30 days prior to surgery for the comfort and convenience to our patients.

Wire Localizations
The breast radiologist numbs the patient’s breast and inserts a wire (or occasionally two or more wires) in the area to be removed. A post procedure mammogram examination will be performed to confirm placement of the wire(s). The patient is then sent to the operating room for surgical removal of the area.

If you have been recommended for a breast biopsy, it is important that you read the following information about the procedure.
  • If you have not had breast imaging at Sonnenalp Breast Center in Edwards or the Breast Imaging Clinic in Dillon, please bring:
    1. A physician referral
    2. Insurance card
    3. Photo ID
    4. Prior breast imaging and reports
  • DO NOT take any aspirin products for three days before your biopsy; this will help reduce bleeding and bruising.
  • A light meal is encouraged prior to your biopsy.
  • If you feel you need sedatives for anxiety, contact your physician for a prescription. DO NOT TAKE any sedatives until you have arrived at the facility and have signed a consent form. YOU CANNOT sign the consent form after sedatives have been taken.
  • Wear a comfortable two-piece outfit with a supportive bra. Your breast biopsy will take anywhere from 1-2 hours. The procedure will be explained to you, and any questions will be answered. You will have a chance to talk with our certified breast radiologist before the biopsy.
  • Sonnenalp Breast Center and Breast Imaging Clinic do not provide babysitting services. Please make plans for childcare while you have your procedure.
  • Your physician will be notified 3-4 business days after your biopsy regarding the results, and should contact you. If you have any questions or concerns regarding your breast biopsy, please call the number listed below. We will be happy to help you at any time.
  • Consider bringing your phone, a book, magazine and/or headphones to your appointment.

​​​​​​​DRUGS WITH ANTICOAGULANT PROPERTIES: The following is a list of drugs that may cause bleeding after your biopsy. Please talk to your physician before you stop taking any medications.

  • PAIN RELIEVERS: Aspirin, Motrin, Ibuprofen, Excedrin, Anacin, Nuprin, Naprosyn, Advil, Bufferin, Mediprin, Aleve, Lodine, lndocin, NSAIDs (non-steroidal anti-inflammatory drugs)
  • FOR ARTHRITIS: Feldene (piroxicam), Trilisate, Vioxx, Celebrex, Relifen
  • BLOOD THINNERS: Coumadin, Persantine, Heparin, Clopidrogril (Plavix), Propoxyphene
  • VITAMINS, HERBALS AND OTHERS: Vitamin E, ginko biloba, feverfew, ginger, garlic, glucosamine, chrondrotin, diet pills, herbal teas, bromelain, flaxseed, horse chestnut, licorice, omega-3 fatty acids, papain, St. John’s wort, zinc, kava-kava

We appreciate the opportunity to participate in your care. If you have questions or concerns, contact the Sonnenalp Breast Center, the Breast Imaging Clinic or your referring physician.

FOLLOWING THE BIOPSY:

  • Steri-strips (tape) and a small pressure dressing have been applied to the biopsy site.
  • Some women are sensitive to the adhesive used in the steri-strips. If your skin becomes red, or if you have excessive itching or tenderness, remove the steri-strips and either apply a Band-Aid or leave to the open air.
  • Place the provided cold pack or small ice pack inside your bra on top of the dressing, always keeping the pack on the dressing – NOT ON YOUR SKIN. Alternate between applying the ice pack for 20 minutes and removing it for 20 minutes, until bedtime, or until the tenderness diminishes. You may continue using the ice pack the next day if you wish.
  • Do not shower or bathe tonight. No swimming or hot tub use until the area is healed.
  • Slight bleeding or oozing at the biopsy site is normal.
  • You will probably experience mild discomfort and a small amount of bruising, which may last for a few days. Bruising can be mild to significant and resolve with time. Occasionally there will be a small lump (a hematoma), which takes longer to resolve.
  • DO NOT participate in strenuous activities for 24 hours (e.g. tennis, yoga, golf, running, skiing, lifting any objects weighing more than five pounds).
  • If you need to take something for pain, take Tylenol or Ibuprofen (Advil, Nuprin, Motrin, etc.). DO NOT TAKE ASPIRIN FOR 24 HOURS.
  • If bleeding occurs and soaks through the bandage, sit and apply pressure with the palm of your hand for 10 minutes or until it stops. Once it stops, you may apply a clean Band-Aid, wear a sports bra and apply an ice pack. If the bleeding continues, please call us or your physician. If you are having issues after hours, go to the Emergency Department.

THE DAY AFTER YOUR BIOPSY:

  • Remove the pressure dressing, leaving the steri-strips in place. No dressing is needed unless the area is irritated by your clothing.
  • You may bathe or shower.
  • Do not use peroxide or any other medicated ointment unless instructed to do so by the Breast Center staff or your physician.
  • You may resume normal activities.
  • The steri-strips are designed to curl up slowly at the edges, and will fall off in 3-4 days. If they fall off sooner, apply a Band-Aid. If the steri-strips are still present four days after your biopsy, you may remove them.
  • Your tissue will be sent to pathology, and your doctor will be called with the results. The pathology can take up to three days to be released.
  • A six-month follow-up mammogram or ultrasound is usually recommended to recheck the area if your biopsy is benign (no cancer). A reminder letter will be sent to you.