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Punch biopsy

A punch biopsy of the breast is a way of taking a sample of cells from the skin of the breast.

What is it?

Your doctor or nurse uses a small cutting device to take the sample. The samples can then be examined under a microscope. This can help to diagnose non-cancerous skin conditions, such as eczema. It can also show conditions, such as inflammatory breast cancer or Paget's disease.

You might have this test in the outpatient department of the hospital. Or you might have it in a one-stop breast clinic after other tests, such as a breast x-ray (mammogram) or ultrasound.

You might have this test if:

  • there are changes in the skin of your breast
  • your breast feels hot or inflamed
  • there are changes in the nipple or surrounding area (the areola)
  • you have pain or discharge from the nipple

Preparing for your punch biopsy

You are able to eat and drink normally before a punch biopsy. Take your medicines as normal. But if you are taking any blood thinning medicines you might need to stop them before the test. Your doctor or nurse will tell you when to stop.

What happens

Your doctor or nurse will give you information about the procedure. They may ask you to sign a consent form. This is a good time to ask any questions that you have.

Having a punch biopsy takes a few minutes, but you will be with the doctor for about 20 minutes. Part of this time is making sure you understand the procedure and you are comfortable.

A member of staff will ask you to take off your upper clothing, including your bra. You might put on a hospital gown. You then lie on a lie on a couch, when you are comfortable the doctor will start. 

The doctor or nurse cleans the breast area. They use a local anaesthetic to numb the skin, which might sting a little. When the area is numb they gently take a small circular area of your skin using a cutting device like a tiny apple corer. The sample includes layers of breast tissue just under the skin.

You will feel some pressure on the breast but it shouldn’t be too painful. Do let the doctor know if it’s painful, you may need a little more local anaesthetic.

The sample is put into a small pot and sent it to the laboratory to be examined under the microscope.

After the doctor has taken the sample, they put pressure on your breast where they took the biopsy from. This is for a few minutes to try to prevent bleeding or bruising.

You will have dressing put over the site, this is usually a paper stitch with a waterproof dressing over the top.

After your punch biopsy

You can get dressed and go home or back to work straight afterwards if you like. But try not to do too much for the rest of the day.

You can take paracetamol if your breast is sore or tender.

Your doctor or nurse will let you know how to look after the biopsy area and your dressing. You can have a shower or bath as normal if you have a waterproof dressing.

You might see some bruising in the area and this is normal. It will go after a week or two.

Getting your results

You should get your results within 1 or 2 weeks at a follow up appointment. 

Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.

You can also contact the Cancer Research UK nurses on freephone 0808 800 4040 for information and support. The lines are open from 9am to 5pm, Monday to Friday.

Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

Possible risks

A punch biopsy is a very safe procedure but your nurse will tell you who to contact if you have any problems after your test. Your doctors will make sure the benefits of having a punch biopsy outweigh these possible risks.

Bleeding

It’s rare to have any bleeding after your punch biopsy. Your doctor or nurse will give you advice on what to do if you have any bleeding.

Swelling

Some people have swelling after the test but this is rare. Let your doctor or nurse know if the area is swollen or very painful.

Information and help