A stereotactic breast biopsy uses specialized mammography to precisely locate and sample suspicious breast areas. This minimally invasive diagnostic procedure is performed when abnormalities, such as tiny calcium deposits (microcalcifications) or architectural distortions, are detected on a mammogram but cannot be felt or clearly seen with ultrasound. Its purpose is to obtain tissue samples for microscopic examination, determining if cells are benign or cancerous.
Why a Stereotactic Breast Biopsy is Performed
A stereotactic breast biopsy is recommended when a mammogram reveals specific findings requiring further investigation. Common indications include suspicious microcalcifications, which are tiny calcium deposits often too small to be seen on other imaging, making mammographic guidance essential. Another reason is architectural distortions, changes in breast structure that may indicate an abnormality. This guidance is preferred for non-palpable areas not visible with ultrasound. The procedure precisely targets these subtle mammographic findings using X-ray images from multiple angles to determine exact three-dimensional coordinates.
The Stereotactic Biopsy Procedure
The procedure begins with the patient positioned for optimal breast access and comfort. Typically, the patient lies face down on a specialized table with an opening for the breast. An upright system may also be used.
Once positioned, the breast is compressed between two plates for stability. Mammographic images are taken from at least two angles, creating “stereo images.” A computer analyzes these to pinpoint the abnormality’s exact three-dimensional location.
After coordinates are determined, the skin is numbed with a local anesthetic, which may sting briefly. A small incision, typically a few millimeters, allows for insertion of a specialized biopsy needle. This needle is advanced to the identified location, guided by the computed coordinates.
Many procedures use a vacuum-assisted biopsy device to collect multiple tissue samples with a single insertion. This device uses suction to draw tissue into the needle, removing several small core samples. This method often provides larger, more comprehensive samples than traditional core needle biopsies, potentially leading to a more accurate diagnosis.
After samples are collected, a small metal marker clip is often placed at the biopsy site. This clip marks the biopsied area for future imaging or treatment. Compression is then released, and pressure is applied to minimize bleeding.
Preparing for and Recovering from the Biopsy
Preparation for a stereotactic breast biopsy involves informing your healthcare provider about all medications you are taking, especially blood thinners, aspirin, or herbal supplements. These may need to be stopped for several days before the biopsy to reduce the risk of bleeding. It is also important to disclose any allergies, particularly to anesthetics.
On the procedure day, avoid applying deodorant, antiperspirant, lotion, or talcum powder to the breast and underarm area, as these can interfere with imaging. Wear loose, comfortable clothing and leave jewelry at home. The procedure is generally outpatient.
After the biopsy, expect mild discomfort, bruising, and swelling at the site. Apply ice packs and take over-the-counter pain relievers as advised. Avoid strenuous activities, heavy lifting, and intense exercise for 24 to 48 hours to promote healing and reduce complications.
Monitor the biopsy site for complications like excessive bleeding, increasing pain, significant swelling, redness, or discharge, and contact your healthcare provider if these occur. Most individuals resume normal activities quickly with minimal recovery.
Interpreting Your Biopsy Results
After tissue collection, samples are sent to a pathology laboratory for microscopic examination by a pathologist. The pathologist examines the samples to determine the nature of the cells, looking for benign, atypical, or malignant changes.
Biopsy results are typically available within a few days to a week. Results fall into different categories, each with specific implications. A benign diagnosis means the area is non-cancerous, usually requiring no further immediate treatment, though follow-up imaging may be recommended.
An atypical or high-risk finding suggests cells are not cancerous but show abnormal features that could increase future cancer risk. Additional monitoring or surgical excision may be recommended. A malignant diagnosis confirms cancerous cells, informing treatment planning.
Regardless of findings, a healthcare provider will discuss the biopsy results in detail. This includes an explanation of the diagnosis, its implications, and recommended next steps like further imaging, additional biopsies, or treatment planning. Understanding these results is important for breast health management.