A breast biopsy is a minimally invasive procedure where a small tissue sample is removed for laboratory analysis, typically to investigate an abnormal finding on an imaging test. Due to the effective use of local anesthesia, the procedure itself is generally not painful. Patients are awake but should expect to feel sensations of pressure, pushing, or tugging rather than sharp pain. The most uncomfortable part is usually the initial injection of the numbing medication, which causes a temporary sting similar to a dental procedure.
Sensations During the Biopsy
Once the numbing medication has fully taken effect, the sensation of pain is replaced by a feeling of deep pressure as the physician works within the tissue. During a core needle biopsy, a specialized, hollow needle is inserted through a small incision in the skin. You may feel a significant pushing or pulling sensation as the needle is advanced toward the target area.
The spring-loaded device used to collect tissue samples often makes a distinct, loud mechanical click or popping sound. Patients are usually warned about this sound beforehand to prevent them from being startled. For a vacuum-assisted biopsy, which uses suction to draw tissue into the needle, a whirring or sucking sound may also be heard. These sounds are normal and do not indicate pain, as the area should be completely numb.
Preventing Pain During the Biopsy
Pain is prevented primarily through the application of a local anesthetic, most commonly lidocaine, which temporarily blocks nerve signals in the area. The medicine is injected directly into the skin and the deeper breast tissue surrounding the biopsy site. This initial injection is the source of the temporary stinging or burning sensation that patients report.
The anesthetic takes effect quickly, often within seconds, ensuring the remainder of the procedure is comfortable. Some physicians use lidocaine buffered with sodium bicarbonate, which can reduce the burning discomfort of the injection. Once the anesthetic is working, the patient should feel only pressure; if sharp pain is felt, more numbing medication can be applied immediately. Sedation is rarely required for these minimally invasive needle biopsies, allowing the procedure to be performed safely in an outpatient setting.
Managing Discomfort After the Procedure
After the local anesthetic wears off, which takes a few hours, it is common to experience mild soreness, tenderness, and swelling at the biopsy site. Bruising is a frequent occurrence, especially after a core needle or vacuum-assisted biopsy, and may take one to two weeks to resolve. Applying an ice pack wrapped in a towel for 10 to 15 minutes at a time during the first 24 to 48 hours can help minimize swelling and reduce bruising.
Discomfort is typically well-managed with over-the-counter pain relievers such as acetaminophen. Patients should avoid taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen unless instructed by a doctor, as these can increase the risk of bleeding.
Wearing a supportive bra, such as a sports bra, continuously for the first 24 to 48 hours may also help to reduce movement and provide comfort. Contact your healthcare provider if you experience severe, unmanageable pain, excessive bleeding, or signs of infection, such as redness, warmth, or pus.