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.