This retrospective study surveyed women about their experience with image-guided breast biopsies in a rural cancer center. Our study objectives were to determine: women's perception of their emotional and physical comfort during the biopsy; the clarity and acceptability of the communication about the biopsy, as well as the methods used to provide the results of her biopsy and treatment options; and the overall impressions of the technical and personal care she received. A single mailed survey of 500 biopsy patients. The response rate was 43% (n = 215). Prior to their biopsy, 22% had been concerned that the biopsy would be painful and 43% were concerned that the biopsy might show cancer. Almost all women rated the communication about the biopsy procedure as understandable (99%) and accurately reflecting their experience (99%.). Most (77%) patients characterized the biopsy as producing minimal discomfort, although 5% disagreed. Most patients (98%) characterized their physician and technologists as caring about their emotional and physical comfort. Most patients felt that the typical 1-day wait to receive the results of their biopsy was reasonable (90%) and that the use of the phone to convey the results was acceptable (90%). On comparing patients with a diagnosis of cancer to those without, there was no difference in the level of satisfaction with the use of the phone to communicate biopsy results. This study offers encouragement that communication practices can alleviate the anxiety of women undergoing image-guided breast cancer biopsies.