Whenever a suspicious lump or mass is detected inside the breasts, an ultrasound or mammogram is done to detect its potential as a cancerous abnormality. If the lump, tumor or mass looks cancerous, a doctor would also do a biopsy which would involve cutting off a small portion of the tumor or lump for careful examination.
In some cases, it would be hard to biopsy an abnormality that cannot be felt by hand during a routine breast exam, is too small to be felt properly or is too deep inside the breast. In these cases, the doctor would recommend a stereotactic breast biopsy, a technique that is used to biopsy abnormalities that cannot be biopsied surgically or by other traditional methods.
A stereotactic breast biopsy has several other names including stereotactic core needle biopsy, breast stereotaxy, mammographically guided breast biopsy, stereotactic guided biopsy and mammotome vacuum assisted biopsy.
Advantages of Stereotactic Breast Biopsy
A stereotactic breast biopsy can be used to take a tissue sample of an abnormality that is located at a specific area inside the breast. It can also be used as a successful alternative for surgical incision biopsy that would be more painful and leave scars on the breasts afterwards.
The accuracy of stereotactic breast biopsy is also considered to be better than traditional biopsy procedures like the freehand needles aspiration biopsy or the ultrasound guided biopsy. In stereotactic breast biopsy, two dimensional images of the breast (in which the abnormality is located) are captured from different angles .
These images are then fed into a computer that analyses the data shown through different angles and calculates the exact location (in a three dimensional format) of the abnormality within the breast. This information would then be used by the doctor to carefully (and correctly) maneuver the biopsy needle to the spot in order to take tissue and fluid samples of the abnormality.
When compared to an open surgical biopsy, a stereotactic breast biopsy would be simpler, less expensive and less invasive. The procedure would also take less time to complete when compared to traditional biopsy methods and would facilitate quick healing of the biopsy site as well.
The Actual Procedure Involved in a Stereotactic Breast Biopsy
A stereotactic breast biopsy can be carried out with the help of several options, the most common of which include fine needle aspiration, a vacuum powered device, a hollow (or core) needle or the combined use of the vacuum powered device and a needle.
A woman undergoing a stereotactic breast biopsy would be asked to remove her dress from the waist up and lie down on her stomach on the biopsy table which would have an opening for the breast (which needs to be biopsied) to hang through. The biopsy would then be performed from underneath the table. In some cases, the woman may be asked to sit upright for the procedure as well. Before performing the biopsy, the doctor would numb the area with a local anesthetic. An assistant would then press the breast down or compress it to make sure the latter does not move (or you don’t move) during the biopsy.
With the three dimensional images to guide him/her, the doctor would make a small incision on the surface of the breast exactly above the detected abnormality. This would be followed by injecting a small needle or sheath attached to a digital mammogram machine into the breast and guiding it to the abnormal growth inside the breast. The needle or sheath would be used to cut tissue samples at the site of the abnormality while a suction device and special blades would be used to collect the tissue samples along with a little bit of fluid collected in the area.
In the case of a surgical biopsy, a small metal wire, needle or clip would be placed inside the breast at the site of the biopsy in order to help guide future biopsies. A needle or sheath would only enable the removal of small amounts of tissue samples for examination. If the doctor wants a bigger tissue sample, he/she may opt to use a mammotome or an Advanced Breast Biopsy Instrument (ABBI) during a stereotactic breast biopsy procedure.
While a mammotome uses a rotating blade to cut out cylindrical portions of the breast tissue from the area, an ABBI would use a rotating blade and a heated (electrically) wire to remove comparatively larger portions of the breast tissues from the site of the biopsy.
After the respective device (needle, sheath, vacuum, mammotome or ABBI) is removed from the breast, the wound is dressed up with a bandage. The doctor may also opt to apply some ice on the wound to curb bleeding. Although stitches are not needed to cover up the incision made for the biopsy, steristrips may be used to thwart infections. The entire procedure (including the time for X -Rays) would only take about an hour or so.
Stereotactic Breast Biopsy Results
Stereotactic Breast Biopsies would provide the same results as that of normal biopsies, but with higher accuracy. Accordingly, the result of a stereotactic breast biopsy would either be normal which indicates that the tumor is non malignant, or abnormal which indicates that the growth may be cancerous or could become cancerous in the days to come.
Risks Associated with Stereotactic Breast Biopsy
As in the case of any kind of breast biopsy, Stereotactic Breast Biopsy can have some risks associated with it. For instance, a vacuum powered device used for the biopsy can leave a visible scar on the breast as well as cause internal scarring.
These internal scars can show up on future ultrasounds and mammograms and look like abnormal growths as well. To avoid this, the doctor would usually place a metal wire at the biopsy site as a tag for future biopsies. A slight amount of swelling and bruising may be experienced in and around the biopsy site after the procedure. These symptoms would usually go down within 24 hours and can be curbed with the help of pain killers and cold compresses.
A stereotactic breast biopsy could also lead to an infection near the biopsy site. In certain cases, the biopsy site may start bleeding or draining pus. This would usually be followed by extreme pain and discomfort in the area. If this is the case, the patient would need to get in touch with the doctor as soon as possible.
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