What is the role of excisional and incisional biopsy in breast disease?

Excisional biopsy removes the whole lesion - used for diagnosis and as treatment of a benign lesion (e.g. a symptomatic fibroadenoma) or when needle biopsy is inconclusive.

Incisional biopsy removes part of a lesion and is generally not done now for breast lumps (core biopsy has largely replaced it), though it may occasionally be used for large/inoperable masses.

Clinical relevance. Knowing the limited role of surgical biopsy (excisional for benign/inconclusive; incisional rarely) reflects core biopsy as the standard.

More Detail

Excisional and incisional biopsy

These surgical biopsies have a limited, defined role now that needle biopsy is standard.

Excisional biopsy

• Removes the entire lesion.
• Uses: diagnosis and treatment of a benign lesion (e.g. an enlarging/symptomatic fibroadenoma), or when needle biopsy is inconclusive/discordant.

Incisional biopsy

• Removes part of a lesion.
• Not generally done for breast lumps now - core biopsy has largely replaced it (less invasive, gives histology).
• Occasional use: a large or locally advanced/inoperable mass where a representative tissue sample is needed and core biopsy is inadequate.

Context

• Most diagnosis is now achieved by image-guided core biopsy within triple assessment, reserving surgical biopsy for specific situations.