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Harvard Medical School
A surgical biopsy is done in an operating room. An IV line is placed in your arm so that you can receive medicines through it. The doctor may use local anesthesia with sedation to help you relax during the procedure, or general anesthesia. Surgical biopsies take about an hour, and the recovery period is less than two hours.
An open biopsy that removes only part of a lump of suspicious tissue is called an incisional biopsy; one that removes the entire lump is called an excisional biopsy. An incisional biopsy is usually done when the lump is quite large, since removing a larger lump completely can alter the appearance of the breast. This procedure is appropriate for larger lumps in order to secure a diagnosis while minimizing the effect on the breast's appearance. If the tissue proves to be cancerous, the remaining portion of the lump will be removed surgically during a second surgical procedure that may be more extensive and involve removal of lymph nodes to determine whether the cancer has spread.
When a breast mass or an area of calcification cannot be felt, the surgeon may choose to use a procedure called needle localization (or wire localization) to help identify the tissue for later surgical biopsy. The first part of this procedure is a mammogram. After applying a local anesthetic, the doctor inserts a hollow needle into the breast and, guided by ultrasound or mammography, places the tip of the needle in the suspicious area. He or she then inserts the front end of a thin wire with a hook on the end through the hollow needle and into the breast alongside the suspicious area. The doctor then removes the needle, leaving the wire in place to serve as a guide to help a surgeon find the area of breast tissue to be removed later.