Either you or your doctor may find a breast abnormality that requires tissue sampling to diagnose. A biopsy is a medical procedure to obtain a tissue sample from a patient for analysis. A biopsy of the breast is done when your mammogram or ultrasound raises the possibility that an irregularity might be cancer.

It's important to do a biopsy when one is indicated, but there may be a downside, particularly if the technique used is a surgical procedure called an open excisional biopsy. In this procedure, a chunk of breast tissue is removed.

Scarring from the procedure can cause your future mammograms to appear abnormal. Then, the question becomes, "Is this scar tissue from the biopsy or a new abnormality?" Often, the answer is, "Let's do another biopsy to find out." If this cycle is repeated over a number of years, the breast is literally whittled away.

I met such a woman this morning. She now has about one-third of the tissue in one of her breasts left after five years and 12 biopsies. Though technically her breast is "still there," it sure doesn't look it. She knows it, too, and tucks a shoulder pad inside her bra to make up for the lost volume. She came to our breast center to be evaluated for yet another abnormality.

Though this is our first time seeing her, she has decided to go for broke and is considering a prophylactic mastectomy with reconstruction to rebuild what she has lost over the last five years. She hopes this step will get her off the biopsy treadmill she seems to be stuck on.

This woman's situation illustrates one reason it's important to be in the hands of breast specialists from the start. More than 90 percent of biopsies can be done as core biopsies, a nonsurgical technique that does not require an incision or loss of breast volume. A core biopsy also prevents the excessive scarring that reduces the chances that future mammograms will look abnormal.

Don't avoid having a biopsy when one is recommended. But don't rush to sign up for an open surgical biopsy until you've got proof that a core biopsy (done as a minimally invasive procedure) has been ruled out in your case. Otherwise, you are subject to the "whittle-ectomy" approach.

Did you know . . . 90 percent of breast cancers can be found using mammography and ultrasound.