BIOPSY BASICS: What a Biopsy Reveals

Advocates for Breast Cancer: Biopsy Basics

In our last blog we explained what a biopsy is, the 3 different kinds of biopsy that can be performed – as well as what to expect if you are going to have one done. But what exactly will the doctor be looking for when the results come through?

From an advocacy aspect, the same diagnostic tools are used in both the Public and Private sector in South Africa – and a management decision is made by a team of specialists using all the information they can get. eg. (This will include the size of the tumour and whether it has moved into the lymph system.)

If the biopsy results show the presence of cancer, the doctor will also be able to see exactly what kind of breast cancer you have. And because there are so many different types of breast cancer, a wide variety of treatment options are available.

In terms of our goal of lobbying government to create an implement an effective and equitable BREAST HEALTH POLICY, this is an important fact to note: malaria or TB are ‘single’/simple diseases which only need one kind of treatment — thus making them more ‘affordable’ diseases for the government to manage, as opposed to the complex — and expensive — variety of breast cancer treatments!

The biopsy results help the surgeon and the oncologist to decide on the right treatment for the right patient at the right time. Tumours can be separated into 4 main types based on their ‘histological’ type (i.e. the type of tissue where the cancer originates), the grade of tumour (how fast it is growing) and whether the breast cancer cells have receptors for the hormones, oestrogen and progesterone. These hormone receptors are proteins (found in and on breast cells) which pick up hormone ‘signals’, telling the cells to grow.

Therefore, a cancer is called oestrogen-receptor-positive (ER+) if it has receptors for oestrogen. A cancer is progesterone-receptor-positive (PR+) if it has progesterone receptors. This means: cancer cells can receive signals from hormones which could make them grow faster.

***FACT: about 2 out of every 3 breast cancers test positive for hormone receptors.***

Her-2-neu Oncogene: A biopsy will also tell the doctor about the cancer’s Her-2-neu oncogene status — i.e. if there is a genetic link to the type of cancer you have. (Watch the video below for an excellent visual summary of Her-2-neu.)


Guest post by Dr Judith Whittaker, consulting pathologist.

Dr Judith Whittaker - Oncologist

What is a Tissue Biopsy?

Advccates for Breast Cancer - South Africa - Types of Biopsies

One of the things that could happen as part of the breast cancer diagnosis process is that the doctor may ask for a tissue biopsy.

‘Tissue‘ is one of those words that can be confusing, especially if English is not your first language. In medical terms, tissue is the name given to a group of cells that perform the same function.

For a biopsy, a small sample of tissue will be taken from your body so that it can be examined more closely, deeply and thoroughly. (In many cases, an operation isn’t needed for a sample to be taken.)

The  type of tissue that needs to be removed and where it is situated in your breast will determine what type of biopsy you will need.


  1. The doctor may use a fine needle attached to a syringe (see below) to remove a small amount of tissue from the suspicious area – called fine needle aspiration. (The needle is so thin that you’ll very little.)Advocates for Breast Cancer - South Africa - fine needle aspiration - FNA
  2.  If the doctor needs a larger amount of tissue, a core needle biopsy may be done which uses a fatter, hollow needle. As a result, this type of biopsy is somewhat more paintful, but be assured the area will be numbed before insertion of the needle. Whilst tenderness and/bruising typically occur after the procedure, no scarring occurs.
  3. Sometimes a surgical biopsy may be needed which can be done under either local or general anaesthetic, depending on where in the breast the lump actually is. (A whole lump can sometimes be removed for examination.)

TAKEAWAY: What happens to the tissue after it’s been removed from the breast? We found this fantastic explanation for you: The Journey of a Tissue Biopsy!

***ALSO: Here is a Biopsy FACT SHEET to download and print!