Incisional Biopsy

An incisional biopsy is a diagnostic surgical procedure that involves removing suspicious tissue from a breast to check for cancerous cells. Unlike an excisional biopsy, which often removes an entire tumor, an incisional biopsy removes only a small portion of the abnormality. However, it produces a larger tissue sample than a needle-based biopsy, such as a fine needle aspiration or core needle biopsy.

Many patients who are concerned about breast cancer turn to Tampa General Hospital’s Cancer Institute and Breast Cancer Center. Accredited by the Commission on Cancer (CoC), our Cancer Institute is ranked among the top 10% of hospitals in the U.S. for cancer care. TGH is also a high-volume cancer center, and our multidisciplinary team diagnoses and treats breast cancer every day, resulting in an unrivaled level of expertise.

When Is an Incisional Biopsy Considered?

A surgical breast biopsy, such as an incisional or excisional biopsy, may be performed to evaluate:

  • A complex cyst in a breast
  • A solid or otherwise suspicious breast mass
  • An abnormal cluster of calcium deposits (microcalcifications) within breast tissue
  • A distorted shape or pattern of breast tissue (architectural distortion) seen in a mammogram

As compared to an excisional biopsy, a key advantage of an incisional biopsy is that a benign breast lesion can be properly sampled through a relatively minor surgical procedure with a cosmetically pleasing outcome. A disadvantage is that more surgery may be needed if the lesion is found to be cancerous or otherwise must be removed.

What Does an Incisional Biopsy Involve?

An incisional biopsy is usually performed in an operating room after the patient is lightly sedated and a local anesthetic is administered to numb the breast. If the suspicious tissue cannot be felt or is difficult to find, a radiologist may perform a preoperative localization procedure to map the route to the mass for the surgeon. One option is a wire localization, in which the radiologist precisely positions a thin wire in the targeted tissue. Another option is a seed localization, in which the radiologist uses a thin needle to place tiny radioactive pellets within the breast.

After making a small incision, the surgeon removes a sample of the suspicious tissue along with the guidewire or seed, then closes the incision with adhesive strips or sutures. The biopsy specimen is sent to a lab, where a pathologist microscopically examines it for evidence of cancer. If the pathologist finds cancerous cells in the sample, further surgery may be needed to completely remove the mass along with a slim margin of surrounding healthy tissue.

What to Expect With an Incisional Biopsy

After an incisional biopsy, the sedation typically wears off within a few hours while the patient rests in a recovery room. Most patients go home on the same day as their surgery. Although some soreness may develop at the incision site once the effects of the local anesthetic wear off, any discomfort should resolve within a few days, and the patient can then resume most or all their normal activities. If sutures were used to close the incision, a physician will remove them during the first follow-up appointment.

How Effective Is Incisional Biopsy?

A breast biopsy is the only diagnostic procedure that can conclusively determine whether suspicious tissue is cancerous. Therefore, an incisional biopsy is an important and highly reliable tool for diagnosing breast cancer.

Benefit From World-Class Care at TGH

By offering cutting-edge diagnostic and treatment techniques for breast cancer, TGH further demonstrates its commitment to helping each patient achieve the best possible outcome and quality of life. If you would like to discuss an incisional biopsy with an expert on our team, contact us at (800) 844-4554 to request an appointment.