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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Treatment planning

Lymph node biopsy

Lymph node biopsy

Breast cancer may spread to lymph nodes. If your

lymph nodes feel large upon physical exam, they may

have cancer. Likewise, lymph nodes that don’t look

normal in imaging scans may have cancer.

No biopsy is needed before surgery if the physical

exam and imaging results of your lymph nodes are

normal. If cancer may be present, a sample of tissue

must be removed and tested. The removal of tissue is

called a biopsy. As shown in

Figure 2.2

, there are two

types of lymph node biopsies used for stages I and II

breast cancer. They are FNA (







and core needle biopsy.

Before a biopsy, you may be asked to stop eating,

stop taking some medicines, or stop smoking. Local

anesthesia may be given to reduce pain. An FNA

removes a small group of cells from a node using a

very thin needle and syringe. The needle used in a

core needle biopsy is able to remove a solid tissue

sample. For either biopsy, ultrasound may be used to

guide the needle into the node. A biopsy is generally a

safe test.

The biopsy samples will be sent to a lab and tested

for cancer cells. Further testing of your lymph nodes

may be done at the time of surgery even if the

physical exam, imaging tests, and biopsy results are


Illustration Copyright © 2016 Nucleus Medical Media, All rights reserved.

Figure 2.2 Lymph node biopsies

Breast cancer can spread to the lymph nodes by your armpit. Signs of cancer in lymph

nodes can be found with a physical exam, imaging test, or both. If a test suggests

there’s cancer, a biopsy is needed. An FNA removes a small group of cells and a core

needle biopsy removes a solid tissue sample.