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Stereotactic Breast Biopsy for Breast Abnormalities

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Updated August 12, 2012

Definition of Stereotactic Breast Biopsy:

A stereotactic biopsy is used take samples from a lump that cannot be felt during a breast exam, but can be seen on a mammogram or an ultrasound. A lump deep inside the breast, or an abnormality too small to feel, can be biopsied using this technique.

Stereotactic Imaging Improves Accuracy:

During stereo imaging, two-dimensional digital images of your breast are taken from two different angles. Both images are sent to a computer for image analysis. The computer compares the data from each image and calculates the three-dimensional location coordinates for your breast abnormality. With such precise information to guide the biopsy needle, your doctor or radiologist can accurately sample fluid or tissue.

Other Terms for Stereotactic Biopsy:

  • Stereotactic (mammographically guided) breast biopsy
  • Stereotactic core needle biopsy
  • Stereotactic-guided biopsy
  • Breast stereotaxy
  • Mammotome vacuum-assisted biopsy

Reasons to Have a Stereotactic Biopsy:

When your mammogram shows an abnormality that raises concern, and your doctor needs a tissue sample, a stereotactic biopsy is one way to get tissue from a specific location. Examples of abnormalities could be: a dense, irregularly-shaped mass, microcalcifications, a distortion of breast tissue or internal structure, or a new mass at a previous surgery site. Stereotactic biopsy is a good alternative to surgical biopsy if you or your doctor prefers to try a needle biopsy before opting for surgery.

Stereotactic Guidance Assists Needle Biopsies and Wire Placement:

The accuracy of stereotactic images can assist in several types of biopsy:

Patient Comfort and Biopsy Technology:

Stereotactic biopsy can be done in a clinic or hospital that has special breast biopsy equipment. The equipment consists of a digital mammogram machine, linked to a computer, and a needle guidance system. Since you will be awake during the procedure, but must remain very still, your comfort is very important. Some biopsy equipment is configured so that you can sit in a chair during the imaging and biopsy, while other clinics use a special exam table that you can lie down on. Your breast will be given a local anesthetic, so you should not feel anything other than some pressure.

What to Expect During a Stereotactic Biopsy:

Your breast is numbed, and you are positioned for stereotactic mammography. Some compression is used to keep your breast still. Several pairs of images are taken. A small cut is made in your breast skin, so the needle can enter your breast. Your doctor or radiologist uses the image-guided needle to target the breast abnormality. More images are taken to confirm that the needle is in the right place. Using suction or special blades, fluid or tissue is collected for examination. If you're having a surgical biopsy, a wire will be placed at the location and depth of the tumor to guide your surgeon.

Getting Tagged, Recovery and Self-Care:

A fine needle or core needle biopsy won't leave any internal scars, but a vacuum-assisted biopsy (which may take eight or ten tissue samples) will leave its mark. Because those scars can show up on mammograms and ultrasound, a tiny metal tag, clip, or marker may be left at the biopsy site. This tag should not cause discomfort or harm; it will help radiology technicians locate the biopsy site.

It is normal to have some bruising and swelling after a biopsy. Use cold packs and ibuprofen while you are recovering, which should take about 24 hours. If you have bleeding, drainage or inflammation, alert your doctor.

Getting Results from Your Biopsy:

Your fluid or tissue samples will be given to a pathologist, who will carefully examine and test them. A pathology report will be written and sent to your doctor, who will contact you about the results. Remember that having a biopsy doesn't mean that you have a malignancy, since four out of five biopsies come back negative for cancer.

Accuracy of a Stereotactic Biopsy:

Compared to a freehand needle aspiration or an ultrasound-guided needle biopsy, a stereotactic breast biopsy will give you the most accurate results. The precision of a computer-guided needle, combined with larger tissue samples, yields the most information of any type of needle biopsy. An open surgical biopsy, which removes the largest sample of tissue, may be more accurate than a stereotactic biopsy.

Benefits and Risks of Stereotactic Biopsy

A stereotactic biopsy is less invasive and less expensive than an open surgical biopsy. This is a fairly simple and quick biopsy method, with a short recovery time. You do have a small risk of infection, bleeding, and pain following the procedure. If you are pregnant, or think you may be, let your doctor know so that you can be protected from x-rays used in breast imaging.

Mammotome and ABBI, and MRI Technologies

Two other techniques are used with stereotactic imaging to perform breast biopsy to remove twice as much tissue than is taken with a core needle. Mammotome uses a hollow probe with a rotating blade to suction and cut a cylinder of tissue from the target area. ABBI (Advanced Breast Biopsy Instrument) uses a probe, a circular blade, and a thin, electrically heated wire to capture and remove a cylinder of tissue that is larger than the Mammotome sample. MRI (magnetic resonance imaging) is sometimes used in place of stereotactic mammography.

Sources:
American Cancer Society. How Is Breast Cancer Diagnosed? Stereotactic Core Needle Biopsy. Revised: 09/13/2007.

National Cancer Institute. Improving Methods for Breast Cancer Detection and Diagnosis. Detection and Diagnosis Reviewed: 10/15/2009.

Radiology Info. Interventional Radiology. Stereotactic (Mammographically Guided) Breast Biopsy. Last Reviewed: January 24, 2008.

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