A stereotactic breast biopsy (SBB) is a minimally invasive medical procedure used to investigate suspicious areas within the breast that are visible on a mammogram but cannot be felt during a physical exam. This technique uses specialized mammography equipment to precisely locate and guide a needle to the area of concern, such as microcalcifications or small masses. The purpose of the SBB is to remove small tissue samples for laboratory analysis, which is the only definitive way to determine if the abnormality is benign or cancerous. The entire process, from patient check-in to leaving the clinic, is often completed within a single appointment.
Pre-Procedure Preparation and Setup
The time spent preparing for the biopsy often takes between 20 and 30 minutes before tissue collection begins. After registration, the patient is brought into the procedure room and changes into a gown. The technical setup starts with meticulous patient positioning.
Most commonly, the patient lies face-down on a specialized table, with the breast extending through an opening so the radiologist can work from below. The breast is compressed, much like a standard mammogram, to immobilize the tissue and ensure the target area is stable. The table is then raised to allow the medical team access.
Once positioned, the radiologist takes initial X-ray images, known as stereotactic pairs, to confirm the exact three-dimensional coordinates of the target lesion. A local anesthetic is then administered to numb the breast tissue, which may cause a brief stinging sensation. The team waits a few minutes for the numbing medication to fully take effect before the active sampling phase begins.
The Active Tissue Sampling Duration
The active tissue sampling typically lasts between 15 and 30 minutes, which is short compared to the total appointment duration. The radiologist makes a tiny nick in the skin, inserting a hollow needle advanced to the target location using computer coordinates. Another set of images may be taken to confirm the needle tip is perfectly positioned within the abnormality.
The procedure often uses a vacuum-assisted device (VAD) to collect multiple tissue cores through a single skin incision. The VAD is activated, gently suctioning and cutting small cylinders of tissue for collection. Patients may hear several clicking sounds as the samples are taken and the needle is rotated to sample the area.
The number of samples required influences the overall time, often requiring eight to twelve cores to ensure adequate representation of the lesion. After collection, the tissue samples are sometimes X-rayed immediately to confirm the presence of suspicious elements, such as microcalcifications. This confirmation step is essential for diagnostic accuracy and adds a few minutes to the sampling time.
Immediate Post-Procedure Care and Monitoring
After the final tissue sample is collected, several crucial steps are performed to complete the procedure and prepare the patient for discharge. Before the needle is removed, a tiny metallic clip, or marker, is deployed at the biopsy site to permanently mark the abnormality’s location. This inert clip allows for easy identification of the area on future imaging for follow-up care.
Once the needle is withdrawn, a nurse or technologist applies firm manual pressure to the biopsy site for approximately five to ten minutes to help stop any potential bleeding and minimize bruising. After the bleeding is controlled, a sterile dressing is applied over the small skin incision. No stitches are typically required, as the incision is very small.
The patient is then taken for a final set of X-ray images using the mammography machine. This post-procedure mammogram confirms the accurate placement of the metallic biopsy marker. Following this imaging, a short observation period, usually 15 to 30 minutes, is required to ensure the patient feels well before discharge.
Timeline for Receiving Pathology Results
Receiving the final diagnosis takes several business days, as the tissue samples must undergo complex laboratory processing. The collected samples are immediately sent to a pathology lab where they are prepared, stained, and examined under a microscope by a specialized pathologist. This entire process typically takes about three to seven business days.
Initial tissue processing, which involves fixing and embedding the small cores, often requires an overnight period before the pathologist can begin the detailed examination. Many centers also perform a radiologic-pathologic correlation, where the imaging and pathology teams review the results together. This essential correlation step ensures the findings match the mammogram appearance and can sometimes add a few days to the overall turnaround time.
The final report is then sent to the referring physician or the radiologist who performed the procedure. The patient is usually contacted by one of these providers to discuss the results and determine the next steps, such as scheduling a follow-up appointment or planning further treatment.