Although there is the possibility of guided core needle biopsy, in several cases it is necessary to perform surgical (open) biopsy of a breast lesion in order to identify it. This can happen in case a previously performed core needle biopsy did not lead to a diagnosis or in case the lesion must be fully removed in order to ensure exact diagnosis (e.g. microcalcifications, radial scar etc.). Where the lesion is not palpable, it must necessarily be localized with a special hook wire before it can be removed with precision, without removal of an extra healthy part of the breast. The hook wire is placed before surgery with mammography or ultrasound guidance or during surgery with the help of ultrasounds. Open surgical biopsy is performed in the operation room with local or general anesthesia. In all surgical biopsies, the aim is not only to diagnose the lesion but also treat it by fully removing it; this is done so that a second surgery is avoided.
We always try to guarantee diagnosis with less aggressive methods in order to minimize the need for surgical biopsies, since we believe that the main role of surgery is therapeutic and not diagnostic. After all, this is what all contemporary scientific opinions suggest. We mainly perform surgery to treat and not to diagnose.