The patient is then taken to the operating room, where under IV sedation, the breast tissue is biopsied around the localization wire. The tip of the needle has a curve on it so it doesn't move around in the breast and is placed within the suspicious area seen on mammogram. Now the surgeon makes a small incision in the breast to remove the curved part of the needle and all the breast tissue around it. The lesion is marked by the radiologist on the specimen mammogram, and the specimen taken to the pathology department. If nothing is visible, such is the case when this procedure is performed for clustered microcalcifications, then permanent histology is used to render the final diagnosis.
Permanent histology is more accurate than frozen section but takes longer.
If nothing is visible, pathologist are hesitant to waste valuable biopsy tissue trying to cut it for frozen section determination. They would much rather wait for permanent histology, an examination that takes 2-7 days. The operation may occasionally take bit longer if the mammogram of the specimen doesn't clearly shown that the suspicious lesion was removed, usually necessitating that the surgeon remove additional breast tissue. There is usually only moderate pain associates with this procedure - many women do not require narcotic pain pills, but your doctor will usually provide a prescription for some anyway. These can usually be treated with antibiotics and rarely the need to do more.