Breast biopsy - stereotactic

Definition

A breast biopsy is the removal of breast tissue to examine it for signs of breast cancer or other disorders.

There are several types of breast biopsies, including stereotactic, ultrasound-guided, MRI-guided and excisional breast biopsy. This article focuses on stereotactic breast biopsy, which uses mammography to help pinpoint the spot in the breast that needs to be removed.

Alternative Names

Biopsy - breast - stereotactic; Core needle breast biopsy - stereotactic; Stereotactic breast biopsy; Abnormal mammogram - stereotactic breast biopsy; Breast cancer - stereotactic breast biopsy

How the Test is Performed

You are asked to undress from the waist up. During the biopsy, you are awake.

You are most likely asked to lie facing down on the biopsy table. The breast that is being biopsied hangs through an opening in the table. The table is raised and the doctor performs the biopsy from underneath. In some cases, stereotactic breast biopsy is done while you sit in an upright position.

The biopsy is done in the following way:

The biopsy itself is done using one of the following:

The procedure usually takes about 1 hour. This includes the time it takes for the x-rays. The actual biopsy takes only several minutes.

After the tissue sample has been taken, the needle is removed. Ice and pressure are applied to the site to stop any bleeding. A bandage will be applied to absorb any fluid. Stitches are not needed. Adhesive strips may be placed over any wound, if needed.

How to Prepare for the Test

The provider will ask about your medical history. A breast exam may be done.

If you take medicines (including aspirin, supplements, or herbs), ask your doctor whether you need to stop taking these before the biopsy.

Tell your doctor if you may be pregnant.

DO NOT use lotion, perfume, powder, or deodorant underneath your arms or on your breasts.

How the Test will Feel

When the numbing medicine is injected, it may sting a bit.

During the procedure, you may feel slight discomfort or light pressure.

Lying on your stomach for up to 1 hour may be uncomfortable. Using cushions or pillows may help. Some people are given a pill to help relax them before the procedure.

After the test, the breast may be sore and tender for several days. Follow instructions on what activities you can do, how to care for your breast, and what medicines you can take for pain.

Why the Test is Performed

Stereotactic breast biopsy is used when a small growth or an area of calcifications is seen on a mammogram, but cannot be seen using an ultrasound of the breast.

The tissue samples are sent to a pathologist to be examined.

Normal Results

A normal result means there is no sign of cancer.

Your provider will let you know when you need a follow-up mammogram or other tests.

What Abnormal Results Mean

If the biopsy shows benign breast tissue without cancer, you will likely not need surgery.

Sometimes the biopsy results show abnormal signs that are not cancer. In this case, a surgical biopsy might be recommended to remove the whole abnormal area for examination.

Biopsy results may show conditions such as:

Abnormal results may mean that you have breast cancer. Two main types of breast cancer may be found:

Depending on the biopsy results, you may need further surgery or treatment.

Your provider will discuss the meaning of the biopsy results with you.

Risks

There is a slight chance of infection at the injection or surgical cut site.

Bruising is common, but excessive bleeding is rare.

References

American College of Radiology. ACR practice parameter for the performance of stereotactic-guided breast interventional procedures. ACR.org website. www.acr.org/~/media/62F6E5A180134DF6A014447BDEB5384D.pdf. Updated 2016. Accessed March 14, 2017.

Parker C, Umphrey H, Bland K. The role of stereotactic breast biopsy in the management of breast disease. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017:666-671.

Wolff AC, Domchek SM, Davidson NE, Sacchini V, McCormick B. Cancer of the breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 91.


Review Date: 2/11/2017
Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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