In this photo,
The patient is being positioned on the table with her breast suspended through an
opening. The xray camera is used to take two views of the breast to pinpoint
the abnormality.One procedure is called the Stereotactic Mammotome Biopsy. In this procedure, the abnormality seen on the mammogram is located within the breast using digital X-rays of the breast taken from two angles.
In this photo,
The patient is being positioned on the table with her breast suspended through an
opening. The xray camera is used to take two views of the breast to pinpoint
the abnormality.
A computer then calculates the proper angle and depth of insertion of a core biopsy needle. This needle is inserted into the breast, using local anesthesia, and several, usually 14 or 15, core specimens are removed. Each core is about two millimeters by fifteen millimeters long. These cores are then sent to the pathologist for diagnosis.
In this photo the
biopsy needle is placed into position. After this, it will be inserted into the
breast through a very small incision (after the skin is anesthetized!) and the
core biopsies will be taken.
The other procedure is called stereotactic wire placement. The purpose of this procedure is to place a wire into the exact location of an abnormality within the breast. The wire is then used by the surgeon to aid in finding the abnormality within the breast during an open biopsy. An open biopsy is performed in the operating room and consists of making an incision in the breast and removing a portion of breast tissue. The ammount removed depends on the abnormality, but it is usually a piece of tissue about one inch in diameter. The wire is used because the abnormality is not palpable (i.e. cannot be felt) and the surgeon must have a way of identifying the location of the abnormality. The procedure for placing the wire is the same as for taking a core biopsy, but a thin needle is used instead of a core biopsy needle. Once the needle is in place, a thin wire is inserted through the needle, and the needle is removed.
Stereotactic imaging has also been used for a technique called Fine Needle Aspiration, in which a thin needle is used to remove cells from an area of the breast for examination on a microscope slide. This procedure has lost popularity as the core biopsy technique has improved.
Newer stereotactic techniques are being studied, including more complete removal of an abnormality than the core biopsy, but still through a very small incision.
Technique Usage Criticized:
The utilization of
stereotactic core biopsy was recently criticized by the
Philadelphia Inquirer. They claimed the technique was not used often enough
because surgeons were reluctant to send their patients to a radiologist for this
biopsy. In South Jersey, this is not a concern. Your surgeon
is able to perform a stereotactic core biopsy, and will, together with you,
decide which biopsy technique is most appropriate in your individual case.
The stereotactic technique is one of many tools available to aid in the daignosis of an abnormality seen on a mammogram. Which technique best suits your particular circumstances is best decided after a thorough history and physical exam, and a review of your mammogram. Remember, the stereotactic technique is for the non-palpable abnormality seen on a mammogram.
The photos used on this page were generously provided by the Fisher
Imaging Corporation.