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What is a Stereotactic Breast Biopsy?
Mammography is an excellent way to detect breast abnormalities, but in many cases it is not possible to tell from the imaging studies alone whether a growth is benign or cancerous. To make this determination it is necessary to obtain a tissue sample for microscopic examination. As an alternative to open surgical biopsy, which removes a larger specimen for microscopic analysis, a hollow needle may be passed through the skin into the suspicious lesion with the help of special breast x-rays. The sample of breast tissue obtained in this way can show whether the lesion is malignant or benign and the procedure is much less invasive than the surgical approach. A special computerized mammography machine uses intersecting coordinates to pinpoint the area of tissue change. This method is called stereotactic biopsy or x-ray-guided biopsy. A pathologist examines the removed specimen and makes a final diagnosis so that treatment planning can begin.
Common uses of this procedure.
A stereotactic breast biopsy is most helpful when mammography shows a mass, a cluster of microcalcifications (tiny calcium deposits that are closely grouped together), or an area of abnormal tissue change but no lump can be felt on careful breast examination. There are a number of biopsy instruments and methods that are utilized with x-ray guidance. They include core biopsy, which uses a large-bore needle to remove a generous sample of breast tissue, and a vacuum-assisted needle biopsy device (VAD), which uses vacuum suction to obtain a tissue sample.
X-ray images also are used to place a guide wire into the suspicious area in order to help locate the lesion during open surgical biopsy, which is performed in an operating room.
An x-ray-guided biopsy often is done when:
? A woman has a mammogram showing a suspicious solid mass that cannot be felt on breast examination.
? A woman has a mammogram showing a suspicious cluster of small calcium deposits.
? The structure of the breast tissue is distorted.
? A new mass or area of calcium deposits is present at a previous surgery site.
? The patient or physician strongly prefers a non-surgical method of assessment.
How does it work?
Stereotactic Breast Biopsy is a nonsurgical procedure completed on
an outpatient basis with a minimum of discomfort and recovery time.
Image North uses the MammotomeŽ Breast Biopsy System for this
procedure.
Upon entering the procedure room, the woman lies facedown on a special
table. The table has a hole through which the breast is placed. The
breast is slightly compressed to immobilize it, just as in a mammogram.
This allows our radiologists to get a clear mammographic image of
the area to be sampled. The table is connected to a computer that
processes digital images. Placement of the sampling device is guided
by a computerized system using x-rays.
 Two images at different angles are taken that allow the computer
to localize the mass and calculate the coordinates. Local anesthesia
is used before the vacuum - operated needle (mammotome) is advanced to the coordinates
that were calculated by the computer.
The advance of the needle is
followed by several images. Once the needle is seen to be in the breast mass
or the breast microcalcification, vacuum-assisted biopsies are
taken.
The patient is awake throughout the whole procedure and
can go home with a Band-Aid® shortly
thereafter. The pathology specimens are sent to a pathologist, and
the results are usually known within two-to-four days.
Benefits VS risks of a Stereotactic Breast Biopsy?
Benefits
- Usually requires only a 1/4" skin incision.
- Generally is performed in less than one hour under a local anesthetic.
- Minimizes discomfort.
- Tissue samples are sent to a laboratory for analysis and pathologic
results.
- Procedure requires no stitches.
Risks
- Capable of sampling a variety of breast abnormalities,
such as microcalcifications, asymmetric densities, solid masses
or nodules.
- Complications are rare, but patients should call right away if
they experience a fever or have much bleeding from the biopsy site.
- Stereotactic breast biopsies are usually sufficient to determine
the nature of the breast mass. However, at times a larger piece
of tissue may need to be removed afterward.
There is a small ( 2 - 8%) chance that the area biopsied may
not be adequately sampled. You may need to repeat this procedure
or a surgical biopsy.
Patient Comfort
Compared to surgery, stereotactic breast biopsy is quick and less
painful. a stereotactic breast biopsy can take 30 to 60 minutes or more. Most women report little or no pain and no scar is left from the tiny skin incision. Many women find that the major discomfort of the procedure is from lying on their stomach for the length of the procedure. This discomfort may be reduced by strategically placed cushions.
Preparation Required
It is not necessary (in fact, it is not recommended) to fast prior
to the biopsy. Wear comfortable clothing on the day of the biopsy.
On arrival, you will be asked to remove your clothing from the
waist up and put on a mammography gown. The technologist will then
discuss the biopsy with you, ask pertinent questions, and answer
any questions you might have and will have you sign a consent form.
Please inform the technologist if you have had a prior allergic
reactions to any medications.
After the test
It is best to avoid strenuous activity for about 24 hours after the
procedure. It also helps to place an ice pack on the breast to
ease any discomfort. Some patients may have a bruise for about
10 days after the procedure, and there may be a tiny scar at the
point where the needle was inserted.
Getting Your Results
Image North has doctors on site to promptly provide analysis and
reporting. In most cases, the results of the test will be available
to the referring doctor before the patient leaves the facility.
The doctors at Image North may discuss the results with the patient,
or privately and securely send the results to the referring physician.
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