Prior to recent biopsy advancements, physicians and surgeons routinely recommended open surgical breast biopsies. While this remains an accurate procedure, it is the most invasive biopsy procedure and results in external and internal scarring. Most patients recover quickly from a breast biopsy surgery; however, some may experience post-operative pain or minor disfiguring of the breast. This is considered general surgery, which requires an operating room, general anesthesia in some cases, and stitches. Because of the hospital and surgical resources needed to perform the operation, open surgical biopsies are more costly than other breast biopsy methods. Because most breast biopsies are for small breast abnormalities that cannot be felt (non-palpable lesions), open surgical biopsies are sometimes viewed as excessive.
Open surgical procedures often involve a two-step process. First, a radiologist identifies the area to be biopsied. Through a process known as wire localization, a wire is positioned in the abnormal breast tissue to identify the area to be cut out and removed during the breast biopsy surgery. Next, the patient is taken to the operating room where she is placed under general anesthesia or a local anesthesia with sedation. A surgeon makes a 1 to 2-inch incision in the breast and removes the localization wire and a large section of tissue, typically about the size of a golf ball. The incision in the breast is then closed with stitches and covered with a protective bandage.