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Stereotactic Breast Biopsy: the surgical biopsy alternative

(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 was inserted.

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.