Breast Cancer Expert Forum
Core needle biopsy vs. excisional biopsy
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Core needle biopsy vs. excisional biopsy

Hello.  I posted a question yesterday and I want to thank you for your prompt answer.  To recap, I have a small breast mass (6mm X 6mm X3mm) that has a single blood vessel detected in the center of it.  The radiologist classified this lesion as a  "likely fibroadenoma" BI-RADS 4A (after ultrasound) and she recommended a core needle biopsy (to be done by her).  My OB-GYN read my report and seems very concerned by the mention that the mass has detectable blood flow.  She recommends that I have an excisional biopsy and "just get it out."  My dilemma is this:  If this lesion seems to have a low rate of malignancy, then I would prefer a core needle biopsy.  If this lesion would seem to have a high percentage of malignancy, then I would prefer to "just get it out" and avoid having two procedures.   My OB-GYN doctor wants me to get it out ASAP and wants me to schedule an appointment with a surgeon.   Yet the radiiologist did not seem too concerned (but did recommend a biopsy).  What do you recommend....a core needle biopsy or a excisional biopsy?
Thank you in advance for your time.  Marci-S.
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Dear marci-s:  Whether to have a core biopsy or excisional biopsy is not always completely clear cut.  Regarding core biopsy: if it is negative, you have not undergone a surgical procedure.  If it is positive, further surgery will be needed.   Regarding excisional biopsy:  if negative, you have undergone unnecessary surgery.  If positive, you may have had the lump removed (although sometimes surgical margins could be positive and repeat excision could be necessary).  You could discuss the situation with a surgeon who may be able to help determine which biopsy would be better in your situation.  
3 Comments
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I need to have a wire inserted to mark the nodule. The Noduel was only seen on the mri not on the mamo or ultrasound. I definetly don't want to go threw another MRI to have the wire inserted. Is there any other technology that you know of that can mark this nodule without going threw a MRI. I have requested a spot impression on the mamo again and also another ultrasound any other test that help mark this nodule before I have the excisional biopsy.
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Girl I hi both done, get ready for some discomfort and pain for awhile. I had to get it done because my mammogram shown pin like spot, but when they went in I had two good side papailloma. I was glad to have them remove, but healing is slow and with God help recovery will speed up.
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