Often, fluid or tissue must be removed from the breast to help the doctor learn whether cancer is present. This is called a biopsy. For the biopsy, the doctor may refer the woman to a surgeon or breast disease specialist.
Sometimes a suspicious area that can be seen on a mammogram cannot be felt during a clinical breast exam. The doctor can use imaging devices to help see the area to then obtain tissue. Such procedures include ultrasound-guided, needle-localized, or stereotactic biopsy.
Doctors can remove tissue from the breast in different ways:
- Fine-needle aspiration: The doctor uses a thin needle to remove fluid and/or cells from a breast lump. If the fluid appears to contain cells, it goes to a lab where a pathologist uses a microscope to check for cancer cells. If the fluid is clear, it may not need to be checked by a lab.
- Core biopsy: The doctor uses a thick needle to remove breast tissue. A pathologist checks for cancer cells. This procedure is also called a needle biopsy.
- Surgical biopsy: In an incisional biopsy, the surgeon removes a sample of a lump or abnormal area. In an excisional biopsy, the surgeon removes the entire lump or abnormal area. A pathologist examines the tissue for cancer cells.
If cancer cells are found, the pathologist can tell what kind of cancer it is. The most common type of breast cancer is ductal carcinoma. It begins in the lining of the ducts. Another type, called lobular carcinoma, begins in the lobules.