Skin Biopsy Biopsy is the process of obtaining bioptic material for further pathological examination under the microscope in order to label various lesions and define their nature. There are several methods. In the Breast the most common ones are Fine Needle Aspiration Cytology (FNA-C), core biopsy (using a thick tru-cut type needle through a small cut under local anaesthesia) and the punch biopsy for the skin. FNAC is a quick procedure that only needs a common syringe as well as corresponding knowledge and capability on the surgeon’s side. It can be performed free handed or under US guidance and it will provide material for cytology. It is the preferred method for liquid materials (cyst aspiration) and will also be preferred where a core needle biopsy is technically challenging or even impossible. It is a common method for evaluating lymph nodes as it is minimally invasive with very low injury risk. Core Needle Biopsy is performed through a small cut on the skin, right above the lesion, under local anaesthetic, using a specific type of needle (tru-cut) which can provide little pieces of tissue for examination under the microscope by the pathologist. It is the preferred method of biopsy for all the different lesions of the breast. However, there are cases where a core needle biopsy is technically challenging or high risk because of the ejection of the needle during tissue collection. It can also be performed free handed or under US guidance depending on the nature and the location of the lesion. It is of higher diagnostic accuracy when compared to the FNA because of the fact that it provides full tissue and not just cells. Core needle biopsy is a breast surgeon’s right hand when it comes to further managing breast diseases and it provides the most reliable way of labeling and evaluation. Excisional biopsy as the name suggests, is nothing other than a small scale surgical procedure that aims to remove the whole lesion, without necessarily obtaining broad margins around it, since it is usually performed on lesions or findings there is no histology report on. It is not routinely chosen, as a proper surgical oncology approach demands the removal of lesions on healthy wide margins and their identification prior to any surgical intervention. Still, it is performed on lesions that should be removed in a preventive manner such as fibroadenomas (benign neoplasia of the breast), which can be characterized with relative accuracy by imaging only prior to surgery. Punch Skin Biopsy is performed in certain cases of lesions with a high level of clinical suspicion that is usually located on the skin of the breast, the areola and the nipple. Such a lesion could be Paget’s disease, a precancerous disease concerning the nipple-areola Complex (NAC). It is performed using certain type of instruments of different calibers which aim to obtain bioptic material that consists of the full thickness of the skin. The material obtained can be examined under the microscope to provide the necessary information that will define further treatment and management.