Stereotactic (Mammographically Guided) Breast Biopsy
In a stereotactic breast biopsy, a special mammography machine uses
Breast X-rays (mammograms) to help guide the radiologist’s instruments
to the site of the suspicious imaging findings.
For this procedure, you lie face down on the biopsy table with the
breast requiring biopsy positioned through an opening in the table.
The mammography technologist will help position and cushion you to
make holding this position as comfortable as possible. The average
time you will remain on the table is around 30 to 45 minutes. During
the procedure it will be very important for you to remain still, as
movement can affect the targeting that is involved in the biopsy.
The table will be raised several feet to allow the radiologist to
perform the procedure from underneath the table. The breast will be
firmly compressed between two plates, similar to a mammogram. At first
this compression will feel uncomfortably tight, but later the feeling
gets better and most patients usually tolerate it well.
After finding the exact area of concern with specialized mammograms,
the skin is cleansed with antiseptic and the area of biopsy is
anesthetized with numbing medication. A small incision measuring about
¼ inches (about 6 millimeters) long is made through which the biopsy
needle is inserted. A vacuum-assisted probe removes several samples to
ensure that the abnormality is adequately sampled. The samples are
sent to the pathology department for further processing and analysis
underneath a microscope.
After removal of the biopsy specimens, one or more small metal
markers measuring about 1/8th inch long (3 mm) are usually placed in
the breast to mark the biopsy site in case a post-biopsy surgery is
needed at a later time. The markers also help the radiologist read the
follow-up imaging studies. There are no known harmful effects from the
metal markers, but occasionally the marker moves to a site in the
breast that is some distance away from the biopsy site. The markers do
not set off metal detectors at the airport, are safe for future MRI,
and are made of metals that have been used in other implantable devices.
After the biopsy is completed, firm pressure is placed over the
biopsy site to help control the small amount bleeding that occurs
during and following the biopsy. The incision is bandaged and
instructions for caring for the biopsy site are explained to you.
Usually a light mammogram is performed after the biopsy to confirm the
location of the marker placed during the biopsy.