Purpose. To investigate symptom distress, quality of life, affective states, and inflammatory biomarkers before and after breast biopsy in women undergoing breast biopsy. Methods. A convenience sample of 47 women undergoing breast biopsy was assessed at the pre- and post-biopsy visits. The assessments included evaluation of fatigue, anxiety, depression, sleep disturbances, positive and negative affect, quality of life using validated self report measures, and a blood draw to determine markers of inflammation. Results. At the postbiopsy visit, a total of 15 participants were diagnosed with breast cancer, and 32 participants received negative biopsy result. The mean anxiety and sleep disturbances scores were in the clinically significant range for the total sample and for the biopsy positive (BC+) and biopsy negative (BC？) subgroups at both time points. For both subgroups, anxiety and sleep disturbances scores did not change significantly from pre- to post-biopsy. A subpopulation of participants in both groups reported moderate-to-severe anxiety, depression and fatigue levels at both time points. The inflammatory markers did not show consistent associations with psychosocial symptoms. Conclusions. A subset of participants in BC+ and BC？ subgroups experience heightened symptom distress and negative impact on quality of life at both pre- and post-biopsy time points. 1. Introduction Widespread use of screening, along with treatment advances, has been credited with significantly reducing breast cancer mortality [1]. However, the screening and diagnostic process can also result in heightened distress, which for some women can persist from months to years with a significant negative impact on quality of life [2–4]. Several studies have documented psychological and symptom distress associated with the screening process and with false positive or inconclusive results [5–9]. For women with suspected breast lesions, the immediate next step after screening is the biopsy process, which includes prebiopsy surgical consultation, followed by a biopsy procedure and finally a discussion of biopsy results. This biopsy process can lead to higher levels of distress compared to screening due to its proximity to a potential breast cancer diagnosis [10–12]. Positive biopsy results can result in heightened anxiety and distress due to thoughts about cancer treatments and prognosis [9, 10]. It is possible that negative biopsy might not completely resolve psychological distress and the fear generated by the abnormal mammogram and subsequent biopsy process [13, 14]. Therefore, it is
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