Open biopsy vs Core Needle biopsy??

I don't think there is any pathology so far - the issue is whether to do a core needle biopsy of a suspicious mass, or an excisional biopsy/lumpectomy, correct?. The benefit of doing the latter is that you do fewer procedures and get surgical pathology that much faster - but you would have to be trusting of the surgeon.

I had a core biopsy and it was a very simple and easy procedure. I liked having time to think about what treatment that I wanted surgically after having the biopsy, so for me I am very glad to have gone that route. I think I would have a hard time not knowing how extensive my surgery would be before I went under.

Also, if you aren't comfortable with your surgeon I would recommend getting another opinion. I don't think that I would be comfortable with someone who pressured me. The surgeon that I had explained things to me about every option available and answered all of my questions but one of my favorite things that she did was to stress that it was my body and my decision.

All I can say is that I had to have both the last time. There was no choice offered.

After core needle biopsy because of pathology which indicated a problem was a need for excisional biopsy. It's all about the path report

If a mass is very, very small a core needle biopsy can sometimes get most or all of it. It is an easier procedure, requiring only a local anesthetic and no surgical admission--the whole shebang from hopping on the table to getting off is under half an hour, tops. The reason to do it that way is to find out whether it's even malignant--if benign you might need nothing further beyond periodic mammograms. If your surgeon insists on going straight from imaging to excisional biopsy, it suggests to me that perhaps he'd rather do it himself rather than entrust it to a breast radiologist (or perhaps the facility where you're being treated doesn't have a breast radiologist). I don't see the point of doing an excisional biopsy, taking a frozen section, and then either closing up or doing a full lumpectomy depending on the results. My surgeon doesn't think while-you-wait frozen sections (which it sounds like what your surgeon wants to do) are any more accurate than core needle samples (maybe less accurate), and you'd be under general anesthesia longer while they wait for the pathology results. It's safer and surer to remove the entire tumor and an adequate margin of apparently non-cancerous tissue, and then wait the 3-5 working days for a full pathological study (including hormonal profile, tumor grade, status of nodes & margins, etc.). Doing the core needle biopsy first is safer for the patient and gives more time to decide on what kind of treatment you want. If you do opt to schedule surgery, you will not only have more time to get ready but when you do have your surgery the surgeon can also do a sentinel node biopsy to avoid unnecessarily dissecting your underarm should your sentinel nodes be negative.

I’ve read of cases in which the core needle biopsy yielded inconclusive results--or came up benign when all factors on the imaging pointed to probable malignancy, or maybe missed the mark because of inadequate guidance provided by the imaging (e.g., mammogram, ultrasound or MRI performed DURING the biopsy to indicate where to place the needle). But that happens maybe 8% of the time, and usually due to inaccurate imaging. Sounds like your surgeon trusts himself more than he trusts the radiologist--which might, rather than being grounded in genuine and justified concern over the radiologist’s competence, be a sign of a turf war. Or the surgeon doesn’t want another doctor in the picture but is not himself skilled in core-needle biopsy (or the core-needle biopsy means a lower reimbursement for him than would an excisional biopsy whether or not followed by lumpectomy). Either first get an image-guided core-needle biopsy by a qualified and experienced breast radiologist, or get a second opinion!

Second surgical opinion would be a good idea.