THE WOMEN'S CENTER
Stereotactic Breast Biopsy
About
Stereotactic breast biopsy is a safe and minimally invasive form of breast biopsy. It is used to obtain tiny samples from an abnormal breast mass for examination by a pathologist. Biopsies are the only definitive way to confirm that a breast abnormality is benign (non-cancerous) or not.
The Test:
Stereotactic breast biopsy is an alternative to open or surgical biopsy. A sample of suspect breast tissue is precisely located with a computer-guided imaging system and removed with a needle. The procedure is completed on an outpatient basis with a minimum of discomfort and recovery time.
What To Expect
Feel free to bring a family member or friend to your appointment for their support.
- You’ll be asked to undress from the waist up and put on a front-opening gown.
- In the biopsy room, you’ll lie on your stomach on a special table with a hole through which the breast is placed and aligned with the imaging unit beneath. You can expect to be in the biopsy room for an hour or longer and you’ll be awake throughout the procedure.
- The physician performing the procedure will have studied your mammogram to become familiar with the location of the abnormal tissue in your breast. A confirming x-ray is taken to insure that the breast is positioned correctly.
- The skin on your breast will be cleansed; then a local anesthetic is injected with a very fine needle. You may feel a slight sting.
- Your breast will be slightly compressed, just as in a mammogram.
- A small nick is made in your skin and a thin, hollow needle is inserted through the nick. Because of the local anesthetic, most patients report only a small amount of discomfort.
- The doctor will use the computerized imaging system to precisely guide the needle to the biopsy area where several small samples will be taken.
- After the needle is removed, a sterile gauze bandage is placed on the skin to prevent bleeding. An ice pack may also be applied. This procedure requires no stitches.
- Before leaving the office, you'll be given instructions for biopsy aftercare that are specific to your individual needs. Your breast should heal quickly, leaving almost no sign of the procedure.
Patient Preparation
When you make your appointment:
- If you are allergic to a local anesthetic medication, let us know.
- Stop taking aspirin, Vitamin E or Ibuprofen for 3 days prior to the procedure. If you are on blood-thinning medication such as Coumadin please call us at 888-1180 x3.
On the day of your procedure:
- Eat a light breakfast or lunch, limiting fluids.
- Wear a two-piece outfit, if possible, since you’ll be asked to undress to the waist.
- Wear or bring a comfortable bra that provides firm support.
- Bathe but do not use deodorant, talcum powder, lotion, ointment or perfume. They can leave a residue on your skin that can affect the quality of the imaging process.
- Just before your procedure, try to empty your bladder. You'll be more comfortable on the table.
Common Uses for the Test
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 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.
Risks and Benefits
Benefits:
X-ray-guided breast biopsy is an excellent way to evaluate calcium deposits or tiny masses that are not visible on ultrasound.
X-ray-guided core needle biopsy is a simple procedure that may be performed in an outpatient imaging center.
Compared with open surgical biopsy, the procedure is completed more rapidly at about one-third the cost. Generally it is not painful and the results are as accurate as when a tissue sample is removed surgically. No breast defect remains and, unlike surgery, x-ray-guided core needle biopsy does not distort the breast tissue and make it difficult to read future mammograms.
Recovery time is brief and patients can soon resume their usual activities.
Use of the VAD may make it possible to remove the entire lesion.
Risks:
Because the VAD removes large pieces of tissue there is a risk of bleeding and forming a hematoma, a collection of blood at the biopsy site. The risk, however, appears to be less than 1 percent of patients.
An occasional patient has significant discomfort, which can be readily controlled by non-prescription pain medication.
Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
X-ray-guided breast biopsy is not infallible. The lesion may be missed altogether or the extent of disease underestimated.
Special care is taken during x-ray examinations to ensure maximum safety for the patient. Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.
