Stereotactic Core Biopsy

This type of needle biopsy is used to sample an abnormality seen on a mammogram. Almost all abnormalities seen on mammography can be sampled this way. This procedure is a less invasive alternative to surgical biopsy. Studies have shown it to be equally accurate to surgery, with both being approximately ninety-eight percent accurate. Stereotactic biopsy is performed on an outpatient basis by one of our doctors with special training in breast procedures. The patient lies on her stomach on a special table with her breast through a hole in the table. The doctor works from below the table to perform the biopsy. During the procedure, the breast is compressed in a way similar to that used to perform a mammogram, but not quite as tight. The area in question is identified with preliminary x-ray images and the breast is cleaned with antiseptic and numbed with local anesthetic. The entire procedure is performed through a small nick in the skin. A needle is inserted and multiple samples of the abnormality are taken to be sent to the laboratory for analysis. Often a small stainless steel clip is placed at the biopsy site at the end of the procedure to make it easier to follow-up the area. This is particularly useful in those cases in which the entire abnormality is removed by stereotactic means. The procedure is usually painless aside from slight discomfort as the anesthetic is given. A nurse is present with the patient throughout the procedure to provide support and information. The biopsy takes about twenty to thirty minutes, but we usually allow a total of two hours for the patient to spend at the imaging center to allow time for registration, pre-assessment and post-biopsy care. After the procedure, pressure and ice are applied to the biopsy site to reduce bruising. A small dressing is applied and the patient goes home with written follow-up instructions and extra ice packs. Patients can drive themselves home and can return to work if they desire. We do ask that for twenty-four hours following the procedure the patient avoid lifting objects more than ten pounds and avoid vigorous physical activity such as aerobics. The patient should keep the biopsy site clean and dry for twenty-four hours following the procedure, avoiding swimming or showering. A sponge bath or tub bath without wetting the biopsy site is fine. Results are usually available in one to two days. If results are benign, we routinely follow the area again in six months with mammography or ultrasound. If there are any suspicious findings seen on pathology, surgery will then be recommended to remove more tissue from the area. Patients should avoid aspirin, Advil, Motrin, Aleve, ibuprofen and similar medications for five days prior to the procedure as these medications can cause bleeding. Acetaminophen (Tylenol) does not increase the risk of bleeding and is the preferred medication for pain during the five days preceding the procedure. Any patient taking coumadin or heparin should speak with one of our nurses or physicians prior to scheduling the procedure. On the day of the procedure, the patient should wear a comfortable two piece outfit and a bra that will provide support for an ice pack after she leaves our facility.