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Background: Rapid microwave processing allows core biopsy results to be obtained within a 3- to 4-h time period. This study was designed to compare the accuracy and reporting time of microwave-processed breast biopsies with samples processed using traditional methods. Methods: Concordance of the preoperative biopsy report with postoperative histology for tumor type, grade, and detection of lymphovascular invasion was recorded for both techniques. Also reviewed were the time taken between day of biopsy and day of reporting, waiting time between biopsy and surgery, and number of preoperative outpatient appointments. Results: In the microwave-processed group (MG; n = 43), there was a 92% concordance rate between preoperative biopsy and postoperative histology for tumor type. In the traditional group (TG; n = 43), it was 80% ( P > 0.05). For tumor grade, there was a concordance rate of 64% in MG and 93% in TG ( P > 0.05). For detection of lymphovascular invasion, there was agreement in 88% of cases in MG and 67% in TG ( P > 0.05). Twenty-five patients from MG were informed of their diagnosis on the day of biopsy. There was no difference in waiting time from biopsy to surgery or number of preoperative outpatient appointments between MG and TG ( P > 0.05). Conclusions: Microwave processing allows safe and accurate immediate histological reporting. As a result, surgical management can be planned at the initial outpatient consultation. [ABSTRACT FROM AUTHOR]