A stereotactic biopsy can help diagnose cancerous cells in breast tissue. Using a mammography machine, a radiologist uses two images of the breast tissue to take a sample of tissue for testing.
The best way to treat cancer is to diagnose it at the earliest possible stage. At this stage, treatment is most effective.
Various screening methods can show lumps or changes that may be cancerous tissue. If these tests show something suspicious, the next step is often a biopsy.
In a biopsy, a radiologist removes a tissue sample and examines it under a microscope to determine whether cancer has developed.
Nowadays, healthcare professionals mostly use imaging technology to guide the biopsy procedure. Often, they use ultrasound, but another option is a stereotactic breast biopsy.
Learn more about stereotactic breast biopsy, including what to expect during and after the procedure.
A stereotactic breast biopsy is a specific kind of biopsy.
Radiologists use specialized mammography machines to help them pinpoint any suspicious areas. These machines provide X-rays from two different angles.
The two sets of images guide the radiologist to the area of concern as they remove tissue samples. A pathologist will then analyze the samples to see if cancer is present.
The outlook for early stage breast cancer is generally positive.
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A doctor may recommend a stereotactic biopsy if a mammogram or other examination finds:
- small deposits of calcium that could be signs of cancer
- atypical changes in breast tissues
- a suspicious lump
- changes in an area where surgery has taken place
- irregularities in breast structure
If tests show an unusual mass or a routine mammogram detects changes in breast tissue, it is important to determine if they are signs of cancer.
A stereotactic breast biopsy can help healthcare professionals analyze tissue samples to understand the health of the breast better.
Mammography equipment uses X-rays to examine the breast. The design helps ensure X-rays only reach the specific bodily area under examination.
The machine can hold, compress, and move the breast into different positions. This allows radiologists to take images of the breast from different angles.
Stereotactic breast biopsies use a special kind of mammogram machine, but it is similar to the one in routine mammograms.
The machine helps radiologists or doctors make sure they get the needle in the right place before taking samples.
The radiologist will use one of two different kinds of needles to collect samples of breast tissue:
- a vacuum-assisted device (VAD), which can suck out several cell samples with only one insertion
- a core needle, which is large and hollow and collects one sample of breast tissue per insertion
According to an older 2013 article, most procedures now use the VAD needle.
Before having a stereotactic breast biopsy, a person needs to tell the doctor if they may be pregnant and if they are taking any supplements and medications.
These medications might include prescription drugs, herbal remedies, vitamins, minerals, and over-the-counter (OTC) medications such as aspirin.
Healthcare experts recommend the following on the day of the procedure:
- wearing comfortable clothing, although the hospital may provide a gown for the procedure
- not using deodorant, talcum powder, perfume, or body lotion around the armpits or breasts
- leaving any jewelry at home
- removing any dental appliances, glasses, and anything else metal that could interfere with the X-rays before the test
Healthcare professionals carry out most stereotactic breast biopsies on an outpatient basis. Individuals remain awake throughout the procedure, which usually takes no more than 1 hour.
A radiologist will usually apply numbing medication before the procedure to help prevent pain.
People generally report little or no pain during the biopsy and no scarring of the breast after.
During the procedure, the person will either:
- sit upright in a chair in front of the mammography machine
- lie face down on a moveable examination table, known as a prone table, which has an opening for the breast to fit through
The radiologist raises the table and performs the procedure from below.
Some find it uncomfortable to lie down and turn their head to one side. Cushions can help reduce this discomfort.
- The radiologist numbs the breast with a local anesthetic. There may be a slight prick.
- Next, they make a small cut on the surface of the skin where the biopsy needle will go.
- The radiologist then steers a needle through the incision and directs it to the area of concern, while two images of the affected area and computer-generated coordinates guide the process.
- When the needle is in place, the radiologist obtains more mammogram images to ensure the needle is in position to acquire a good sample.
There may be clicking or buzzing sounds while the radiologist collects breast tissue samples. Depending on the exact needle for the procedure, the radiologist collects three to 12 samples.
After collecting all the samples, the radiologist will remove the needle. They may place a marker to indicate the location of the biopsy for future reference. This will not affect the shape or appearance of the breast.
Then, they take some final mammogram images.
This kind of biopsy does not need stitches. The radiologist will dress the incision area using Steri-Strips and may apply pressure for up to 5 minutes to stop or prevent bleeding.
After the procedure, the person may experience:
- bruising
- swelling
- soreness
However, ice and OTC pain relievers can help.
The person needs to contact their doctor if they notice:
- skin discoloration
- heat
- draining of fluid
- severe swelling and bleeding
These may be signs of infection that need treatment.
People need to avoid strenuous activity for at least 24 hours, but they can resume everyday activities afterward.
A specially trained doctor called a pathologist, will examine the breast tissue that the biopsy provides. They will determine whether or not cancerous or precancerous cells are present.
They will inform the doctor who ordered the biopsy, and the doctor will share the diagnosis with the person. They can then discuss the next steps.
What do the results mean?
Doctors can gain a lot of information by examining the tissue samples from a biopsy.
If the biopsy finds breast cancer cells, it will also show the type of cancer — such as ductal or lobular — and the subtype of breast cancer.
This information can help doctors and people to develop treatment plans that will address individual needs.
If the breast tissue is typical or shows that an existing lump is not cancerous, the person may still need more tests to confirm that cancer is not present or to help the doctor monitor the breast tissue over time.
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This makes them very useful for determining whether or not a suspicious area in the breast is cancerous.
A stereotactic breast biopsy, like all medical procedures, will involve some risks.
- It is not suitable during pregnancy, as the radiation can be harmful to a fetus.
- It may be difficult to carry out if the person has small breasts.
- There may be some pain, although OTC pain relief medication usually helps.
- A collection of blood, known as a hematoma, can develop on the biopsy site in a small number of people — fewer than 1%.
- One in 1,000 people undergoing the procedure may develop an infection due to the incision.
- In rare cases, the biopsy needle can go through the chest wall and cause complications.
Additionally, the technique is not very effective in cases near the chest wall, where there are widely distributed calcium deposits or with well-defined masses.
If a mammogram or physical examination shows an unusual lump in the breast, a doctor may recommend a biopsy.
In the past, surgery was the only option. Now, a doctor will only recommend surgery if they know that the tissue also needs removal.
The stereotactic breast biopsy uses mammography equipment to guide the needle as it takes a tissue sample. Doctors consider it an effective procedure.