Stereotactic Biopsy

Stereotactic Guided Core Needle Biopsy

A stereotactic biopsy usually must be scheduled in advance because it involves the use of the mammogram machine as well as other special equipment. Mammography-guided biopsies are done for things that cannot be seen with ultrasound, such as clusters of calcifications, some masses and distortion.

The term stereotactic means that a limited mammographic view of the area to be biopsied is taken straight on at first, followed by an image taken at a +15-degree angle and another at a -15-degree angle. The point of intersection of these images is the depth of the finding to be biopsied. The radiologist, aided by the imaging computer, is able to precisely determine the x-axis and the y-axis for the biopsy.

During the procedure, you sit in a padded chair and the breast being biopsied is gently compressed, either side to side or up and down. An opening in one of the biopsy paddles allows access to the breast. Three focused images are taken to determine the exact location of the finding to be biopsied.

Next, the overlying skin is cleansed with betadine or alcohol. Local anesthetic with lidocaine is given to numb the skin. A deeper anesthetic is also given, combining lidocaine with a small amount of epinephrine. The numbing process takes a matter of seconds and is all the pain you should feel during the procedure.

After this, a second set of pictures is taken, each at 15 degrees off midline to confirm that the targeting is still accurate. A small skin incision is made and then the biopsy device is inserted in the area to be sampled. We usually take six core samples within about 15 seconds. The needle is then removed and a tiny titanium clip placed at the site of biopsy to mark the area for future reference. A final mammogram is taken to document the clip.

The entire procedure takes about 20 minutes.

After the biopsy, local pressure is applied until there is no bleeding and a bandage is placed over the wound. Instructions on taking care of yourself after the biopsy are reviewed with you and a copy is sent home with you.

Results are usually available within two business days. Our physicians are available by phone after hours should you have any concerns after your biopsy.

Stereotactic Discussion:

When Pacific Breast Care opened in January 2008, we were one of only for breast health centers in the country with up-right attachments to our digital mammography unit, making stereotactic biopsies possible.

With our unit, we are able to see faint calcifications for biopsy with greater comfort to the patient, who is able to sit upright instead of having to lay on a table with the breast placed through a hole. Patients who have had the more common table biopsies say our upright system is preferable.

Pacific Breast Care is a referral center for patients whose calcifications and masses cannot be biopsied at other facilities, due to the calcifications being too faint, too difficult location within the breast, obesity, recent abdominal surgery or degenerative changes in the neck.