While needing a breast biopsy can be scary, it does not necessarily mean you have cancer.
In fact, about 4 out of 5 breast biopsy results are benign, meaning the tissue is normal and cancer-free. Breast biopsies are typically performed after an abnormality has been detected on an imaging test, such as a mammogram, ultrasound, or MRI scan. During a biopsy procedure, small samples of tissue are taken from the suspicious area. The samples are then examined under a microscope to check for the presence of cancer cells.
Following your exam, you will receive a pathology report detailing your breast biopsy results. Oftentimes, the results can be a bit overwhelming to understand – especially after an anxious waiting period. To help guide you through your report, here’s a comprehensive list of breast biopsy diagnoses and their definitions.
Benign Breast Biopsy Results
Benign means not cancer. When your biopsy result is benign, no other treatment is usually needed.
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Cysts are pockets of liquid in the breast and are very common. Cysts can be large or small and may change in size. If a cyst is large or painful, it may be drained or removed.
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Fat necrosis is one of the ways that the breast heals after an injury. The injury may be something minor that you may not even remember. Fat necrosis may show up at any time, even years after the injury. No treatment is needed.
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Fibroadenomas are growths of solid tissue in the breast. They may grow slowly. If a fibroadenoma is large or is causing discomfort, it may be taken out.
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Fibrocystic changes are areas of fibrous tissue mixed with cysts in the breast. Usually, no treatment is needed.
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Lymph nodes are a normal part of your body that are found in your underarm and in your breast. They may enlarge when your body is fighting an infection or if a cancer has spread to your lymph nodes. If your lymph node is benign, there is no cancer in it.
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Pseudoangiomatous stromal hyperplasia is a harmless type of growth of tissues found in the breast. Usually, no treatment is needed. The area may be taken out if is large or is causing discomfort.
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Here are some other results that are benign and no treatment is usually needed: apocrine metaplasia, columnar cell change, focal stromal fibrosis, inflammation, reactive changes, sclerosing adenosis, usual ductal hyperplasia**
Increased Risk Breast Biopsy Results
Biopsy results which show “increased risk” are not cancer. However, this result could mean that you may be more likely to get cancer in the future. You should speak to your doctor about whether any more treatment is needed.
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Atypical ductal hyperplasia can be thought of as one-step before the earliest form of cancer. It is often removed because there is a small chance that cancer cells may be found nearby.
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Flat epithelial atypia is a growth within a milk gland. It does not usually need to be removed.
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Lobular carcinoma in situ and atypical lobular hyperplasia are grouped together and called lobular neoplasia. These findings are sometimes removed because there is a small chance that cancer cells may be found nearby.
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A papilloma is a growth within a milk duct that may cause nipple discharge. Not all papillomas need to be taken out of your breast. A papilloma may be removed if it has suspicious cells or if it is causing symptoms.
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Phylloides tumors are rare tumors that are most often benign. Because they tend to grow very fast, they are usually removed.
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A radial scar (or complex sclerosing lesion) is a collection of milk ducts trapped in an area of breast tissue. Not all radial scars need to be taken out of your breast. A radial scar may be removed if it has suspicious cells.
Malignant Breast Biopsy Results
Malignant means that some cancer cells were found in your biopsy tissue. There are several types of breast cancer. Each type of breast cancer has different treatment options. You should speak to your doctor about the next steps of your treatment.
The glands of the breast are made of lobules (where milk is made) and ducts (which carry the milk to the nipple). Non-invasive cancers have not yet broken out of the milk glands into the surrounding tissues. Invasive cancers start out growing in the breast glands but have also entered the surrounding tissues. Invasive cancers may also spread outside of the breast.
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Ductal carcinoma in situ is non-invasive cancer. The cancer cells grow and expand the milk ducts but are not in the surrounding breast tissue. It is usually not life-threatening.
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Invasive ductal carcinoma is the most common type of invasive breast cancer. About 80% are this type. The cancer starts in the cells that line a milk duct and grows into the tissues outside of the duct.
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Invasive lobular carcinoma is a less common type of invasive breast cancer. About 15% are this type. The cancer starts in the part of the gland that produces milk (lobule) and grows into the tissues outside of the lobule.
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Invasive mammary carcinoma is a less common type of invasive breast cancer that has features of both ductal and lobular cancer.
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Other less common types of breast cancer are cribriform, inflammatory, medullary, mucinous, papillary, and tubular.
Your breast biopsy results may include other details that help doctors decide on your treatment. A tumor grade, for example, shows how quickly cancer cells are likely to grow and spread. Usually, the grade is between 1 and 3, with 1 being less worrisome. Tumor markers include estrogen receptor, progesterone receptor, and Her2-neu. Knowing about these markers gives your doctor a better idea of how best to treat the cancer.
Sources:
Society of Breast Imaging – Sally Goudreau, Vidhi Kacharia, Vandana Dialani, Hannah Milch, Caroline Daly, and Lars Grimm for the SBI Patient Care & Delivery Committee