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Stereotactic Breast Biopsy

Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by hand (called palpation). In stereotactic breast biopsy, a special mammography machine uses ionizing radiation to help guide the radiologist's instruments to the site of the abnormal growth.

Your doctor may recommend a Stereotactic Breast Biopsy to help identify:

  • A suspicious solid mass
  • A tiny cluster of small calcium deposits
  • A distortion in the structure of the breast tissue
  • An area of abnormal tissue change
  • A new mass or area of calcium deposits present at a previous surgery site

You may be asked to remove some or all of your clothes and to wear a gown during the exam. Women should always inform their physician if there is any possibility that they are pregnant. Some procedures using image-guidance are typically not performed during pregnancy because radiation can be harmful to the fetus. You should not wear deodorant, powder, lotion or perfume under your arms or on your breasts on the day of the exam. Prior to a needle biopsy, you should report to your doctor all medications that you are taking, including herbal supplements, and if you have any allergies, especially to anesthesia. Your physician will advise you to stop taking aspirin or a blood thinner three days before your procedure. Also, inform your doctor about recent illnesses or other medical conditions. You may want to have a relative or friend accompany you and drive you home afterward. This is recommended if you have been sedated.

The specialized mammography machine used in this procedure is similar to the mammography unit used to produce diagnostic mammograms. At most facilities, a specially designed examination table will allow you to lie face down with your breast hanging freely through an opening in the table. The table is then raised and the biopsy procedure is performed beneath the table. At other facilities, the procedure may be performed while you sit in a chair.

The special mammography unit used to perform a stereotactic breast biopsy is a digital mammography machine. In digital mammography, as in digital photography, film is replaced by electronic detectors. These convert x-rays into electrical signals, which are used to produce images of the breast that can be immediately seen on a computer screen. Stereotactic mammography pinpoints the exact location of a breast mass by using a computer and x-rays taken from two different angles. Using these computer coordinates, the radiologist inserts the needle through the skin, advances it into the lesion and removes tissue samples.

One of two instruments will be used:

  • A core needle, also called an automatic, spring-loaded needle, which consists of an inner needle connected to a trough, or shallow receptacle, covered by a sheath and attached to a spring-loaded mechanism.
  • A vacuum-assisted device (VAD), a vacuum powered instrument that uses pressure to pull tissue into the needle.

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