(released in conjunction with the upcoming "Doctor on Call" radio
show scheduled for 10:30 a.m. on Friday, April 14, 2006 on WQMR 101.1FM)
It is estimated that about forty percent of women in the United States
will develop a lump in the breast at one time or another. Fortunately,
about eighty percent of all breast masses are non-cancerous. The challenge
is to determine whether a mass is cancerous or non-cancerous with the
minimum amount of pain, discomfort and scarring. Stereotactic breast biopsy
makes this possible.
Women who undergo routine screening mammograms are often found to have
abnormalities that are not palpable. This means that the mass cannot be
felt during an exam by a health professional or during the women’s
monthly breast self-exam. These lesions are usually less than one centimeter
in diameter. As such, they require an imaging technique, such as a mammogram,
ultrasound or MRI, to find them in the breast.
When a mass has been found the question becomes, is it cancerous or non-cancerous?
The only way to be certain is to have a sample of the mass removed and
reviewed by a pathologist, a doctor who specializes in examining, testing
and diagnosing tissue samples. This is called a biopsy.
Stereotactic breast biopsy, performed by a radiologist, is a non-surgical
procedure completed on an outpatient basis with a minimum of discomfort
and recovery time.
Upon entering the procedure room, the woman lies face-down on a special
table. The table has a hole through which the breast is placed into the
digital mammography unit beneath. The breast is slightly compressed to
keep it still, just as in a mammogram. This allows our radiologist to
get a clear mammographic image of the area to be sampled. The table is
connected to a computer that processes the 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 pinpoint
the mass and calculate the exact spot where the needle will be inserted.
Local anesthesia is used before the vacuum-operated needle is inserted
into the site determined by the computer. The advance of the needle is
followed by several images.
Once the needle enters 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 biopsy specimens are sent to a pathologist, and the results are usually
known within two to four days.
It is best to avoid strenuous activity for about twenty-four 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
The benefits of the stereotactic breast biopsy include:
A small skin incision, usually only a quarter inch, is made. No stitches
are necessary, and there is minimal discomfort. The procedure is generally
performed in less than one hour with a local anesthetic, and there is
no need for general anesthesia.
It is capable of sampling a variety of breast abnormalities, such as microcalcifications
(tiny deposits of calcium) or solid mass.
The risks of stereotactic breast biopsy:
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. Occasionally (two to eight percent chance), the stereotactic
breast biopsy may not be adequate and you may need to repeat this procedure
or have a surgical biopsy.
For more information about Stereotactic Breast Biopsy technology, available
at the Atlantic General Hospital Women’s Diagnostic Center, or to
schedule an appointment, please call 410-641-9215.