Breast Biopsy Made Better
It is something every woman fears - your routine mammogram shows something questionable in your breast. This scenario is not as rare as you might think with approximately one out of 50 mammograms showing an abnormality that requires further examination. You may need a biopsy to find out if it is benign or malignant.
There are a number of methods that are used to biopsy the breast. The newest method is stereotactic biopsy. Stereotactic core biopsy begins by placing the patient prone on the biopsy table with her breast hanging down through a hole in the table itself. Under the table the breast is compressed, just like it is for a mammogram, and two digital xray pictures are taken 30 degrees apart. This enables a computer to calculate the exact position of the abnormality in the breast in 3 dimensions. The skin is anesthetized and a small nick is made through which a hollow needle is inserted to the computer derived coordinates. The doctor fires the needle several times and these cores of tissue are sent to the pathologist for final diagnosis. For biopsy of microcalcifications, the tiny calcifications often associated with malignancy, the Mammotome Breast Biopsy System is a technological advancement that has the ability to sample these tiny abnormalities - which can be the earliest or only sign of breast cancer, with even increased accuracy. The procedure is similar to stereotactic core biopsy. It uses a disposable probe that is inserted into the breast along the stereotactic coordinates and a vacuum line pulls tissue into a sampling chamber. A coaxial cutter cuts a sample away from the breast and it is stored in the lumen of the cutter. The cutter is then pulled back to the specimen retrieval chamber where the specimen is removed. This cycle is repeated after rotation of the probe.
Stereotactic biopsy therefore has many advantages: It is an office procedure that requires the use of only skin anesthesia. The patient experiences only minor discomfort during the procedure, and there is little scarring afterwards. Stereotactic biopsy costs much less than what is charged for a surgical biopsy.
This type of in-office biopsy of suspicious lesions could eventually replace 95 percent of needle directed open biopsies. It is not only less invasive for the patient, but with the increasing number of mammographic abnormalities requiring diagnosis, the cost savings to the health care system will be enormous. Also, because about 70 percent of biopsied lesions end up being benign and using the new equipment removes very little tissue, much less normal breast tissue is lost.
As the public becomes more aware of this procedure, every patient needing biopsy of a suspicious breast lesion should have the option of having stereotactic biopsy whenever appropriate. If you have any questions about these procedures do not hesitate to call Dr. Hertz.