Women's Imaging

What is Stereotactic Breast Biopsy?

Mammography is an excellent method to detect breast abnormalities, but in many cases it is not possible to determine from the study 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, a hollow needle may be passed through the skin into the suspicious area with the aid of a special computerized mammography machine that precisely localizes the area of concern with X-ray guidance. This method of localization is called stereotactic or x-ray-guided biopsy. The small sample of breast tissue obtained is sent to the pathologist for laboratory analysis.

What are some common uses of the procedure?

A stereotactic breast biopsy is most helpful when mammography shows a suspicious mass or distorted tissue not visible with ultrasound or a cluster of microcalcifications that are closely grouped together and could indicate cancer. There are a number of biopsy instruments that can be used to obtain the tissue sample. They include core biopsy, which uses a large-bore needle to remove a sample of breast tissue, and the MammotomeŽ, a vacuum assisted needle biopsy device (VAD), which uses suction to obtain the tissue sample.

What should I expect during the procedure?

Stereotactic breast biopsy can take from 30 to 60 minutes. The first step is to clean the skin and inject a local anesthetic. A small incision is made in the skin and the tip of the biopsy needle is advanced to the calculated site of the lesion. At this point, stereo X-ray images are again obtained to confirm that the needle tip actually is within the lesion. Several tissue samples are then removed, and a final set of images is obtained to verify that the lesion has been adequately sampled. If the lesion has been mostly or completely removed, a small clip is left at the biopsy site so that it can be easily located if further intervention is needed. After the procedure, it is not necessary to close the tiny skin incision. A small compression dressing will suffice. Manual pressure and an ice pack are held over the biopsy area. After a short period of observation, the patient is sent home with a sports bra for support. Patients are instructed to avoid strenuous activity for 24 hours after returning home, but then will usually be able to resume their normal activities.