Breast biopsy

What is a breast biopsy?

A biopsy is a diagnostic method in which a sample of material is taken from a specific tissue. The biopsy of the breast involves breast tissue. Depending on the suspected underlying disease, different regions of the breast can be biopsied. Usually this is due to a suspected lump in the breast, which is now to be examined more closely.


A biopsy of the breast is usually performed when a mass in one breast is detected. This may have been palpated in the form of a lump by the woman herself, or usually by the gynaecologist. Even in early detection examinations such as ultrasound or mammography, conspicuous regions in the breast can be detected, which should be examined for their entity (benign vs. malignant) by means of a biopsy.

Genuine indications for a biopsy of the breast are mainly spatial claims with an unclear origin or a suspected malignancy. This is classified according to the BI-RADS criteria used in mammography. A biopsy should be performed if the BI-RADS value is 4 (= suspicious findings, clarification recommended, suspected malignancy between 2 and 95%) and a BI-RADS value of 5 (highly suspected malignancy above 95%).

The highest BI-RADS value is 6 and indicates breast cancer that has been confirmed by tissue sampling. With BI-RADS values below 4, there are no to slightly (below 2%) suspected malignancies in mammography. A biopsy is not recommended in these cases. If necessary, new imaging of the breast should be performed early (for example after 6 months) to determine the further procedure).

What is a vacuum biopsy?

Vacuum biopsy refers to a type of tissue removal in which a thin hollow needle is used for the biopsy. The needle is usually inserted into the breast under ultrasound control or controlled by MRI images, from where a tissue sample is drawn directly into the hollow needle. The resulting cylinder of tissue can then be examined under a microscope.

What is an open biopsy?

In an open biopsy, the tissue is not removed through a fine canaliculus. Instead, the skin over the suspicious area is first opened, then the suspicious tissue is surgically exposed, after which the tissue sample can be taken. Open biopsies are rarely used because of the rather larger procedure, minimally invasive procedures are preferred (if possible). Since open biopsies are a larger examination with more affected tissue, they are always performed under local anaesthesia, and in the case of major operations even under general anaesthesia.

What is a stereotactic biopsy?

In medicine, stereotactic procedures refer to examination or therapy procedures in which the patient acts from several directions. In stereotactic biopsy, for example, several instruments are directed at the suspicious area in the breast from different directions. Usually the planning is done beforehand on the computer after the evaluation of three-dimensional MRI images. Due to the stereotactic nature of the procedure, a precise biopsy of the breast can be performed. This allows for very precise work while at the same time only a small amount of surrounding breast tissue can be damaged by the intervention.