What does my breast biopsy result mean?

Interpreting Your Breast Biopsy Result

To properly interpret your breast biopsy result, I need to see the actual pathology report, as management depends entirely on the specific diagnosis—whether it shows benign tissue, atypical cells, carcinoma in situ, or invasive cancer.

Without seeing your specific biopsy result, I can provide you with a framework for understanding what different findings mean and what happens next:

If Your Biopsy Shows Benign Findings

If the pathology shows a benign mass (like fibroadenoma or fibrocystic changes) that matches what was seen on imaging (concordant findings), you should have either routine screening or a physical exam at 6-12 months with or without imaging for 1 year to ensure stability. 1

• If the lesion remains stable after this monitoring period, you can return to routine breast screening 1
• If the lesion increases in size during follow-up, surgical excision is recommended 1

If Your Biopsy Shows High-Risk or Indeterminate Lesions

Certain benign-appearing findings on core needle biopsy require surgical excision because they may underestimate cancer. 1

These include:

• Atypical ductal hyperplasia (ADH) - requires surgical excision due to risk of underestimating cancer 1
• Lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH) - if concordant with imaging, you can have physical exam with or without imaging at 6-12 months plus risk reduction therapy, OR surgical excision 1
• Pleomorphic LCIS or LCIS/ALH that doesn't match imaging - requires surgical excision 1
• Multiple-foci LCIS (>4 terminal ductal units) - requires surgical excision due to increased risk of invasive cancer 1
• Papillary lesions, radial scars, mucin-producing lesions, potential phyllodes tumors - may require surgical excision, though select cases can be monitored 1

If Your Biopsy Shows Discordant Findings

If your benign biopsy result doesn't match what the radiologist expected to see on imaging (discordant findings), surgical excision is mandatory. 1

• This discordance suggests the biopsy may have missed the actual abnormality 2
• False-negative rates for core needle biopsy range from 3.6% to 13.3% depending on technique 2

If Your Biopsy Shows Malignancy

Any malignant findings should be managed according to breast cancer treatment guidelines, which will involve additional staging, receptor testing (ER, PR, HER2), and multidisciplinary treatment planning. 1

• Receptor status should ideally be tested on the biopsy specimen to guide treatment decisions 1

Critical Next Steps

You must ensure your pathology result matches the clinical and imaging findings (concordance check). 1, 2

• Your surgeon or radiologist should confirm that what the pathologist found makes sense given what was seen on mammogram/ultrasound
• If there's any doubt about concordance, repeat biopsy or surgical excision is needed 2
• Establishing a standard post-biopsy follow-up protocol prevents delays in diagnosis that can range from 112-336 days 2

What Information You Should Request

Ask your healthcare provider for:

• The exact pathology diagnosis in plain language
• Whether the pathology matches the imaging findings (concordance)
• The specific follow-up plan with timeline
• Whether additional testing or procedures are needed
• Your risk of developing breast cancer in the future

Please share your actual pathology report for specific interpretation and management recommendations tailored to your result.