When an abnormal mammogram detects breast lesions that cannot be felt, additional breast imaging can be used to guide the physician to the suspect area for further evaluation.
In a stereotactic breast biopsy, the physician who is taking samples of the breast tissue to determine if cancer is present is guided by mammography. This minimally invasive outpatient procedure is performed in the facility that houses the breast imaging equipment, typically a breast center or hospital.
Both a mammography technologist and a qualified physician (either a dedicated breast surgeon or radiologist) will be involved in performing the biopsy. Often a breast health nurse will also help the patient prepare for the biopsy and assist the patient after the biopsy has been performed.
To perform a stereotactic breast biopsy, a physician either has a patient lie on a dedicated biopsy table or uses an "add on" device to a regular mammography unit. The area of concern will be “localized” by taking several pictures. The lesion must be in a location that has the right physics for a biopsy. Once the area is in the “target” position, it will be numbed with a local anesthetic. The biopsy device will then be inserted into the breast and its position verified. Additional local anesthetic will be administered through the biopsy device. Several breast tissue samples will then be taken. (If the biopsy is being performed to evaluate calcifications, the specimens will be x-rayed to ensure that they do contain calcifications.) The breast tissue samples will then be sent to a pathologist for analysis. (Once they are available, the patient will be notified of the pathology results with a phone call or office visit.)
After the physician has taken the appropriate samples, he or she will also insert a clip into the breast. The clip, which will be visible on future mammograms, will show the physician which area has been biopsied. Additionally, the clip will:
- Verify that the correct area of the breast has been biopsied
- Guide the surgeon if further breast tissue needs to be obtained
- Let radiologists know, when future mammograms are performed, that the patient has had a biopsy.
NOTE: Not all patients are candidates for a stereotactic breast biopsy. Your doctor will help determine the best method of biopsy if you have an abnormal mammogram.