A stereotactic breast biopsy is a surgical procedure that uses mammography to collect a tissue sample from a breast lump. It is normally done because your doctor suspects the lump might be cancerous.
A mammography is a special form of X-ray used on the breasts. It is recommended as a preventative screening tool for breast cancer in women over the age of 40.
Stereotactic breast biopsies use the X-rays from mammograms to locate problems within the breast. The images help guide a specialist so that he or she can extract a small sample of the tissue. The sample is then tested for cancer cells in a laboratory.
A breast biopsy is typically done to investigate irregularities, such as a lump, in the breast. A breast lump may be frightening. However, according to the Mayo Clinic, breast lumps are benign (or non-cancerous) in about four out of five cases (Mayo Clinic).
A breast biopsy is typically done if your doctor becomes concerned following a mammogram or breast ultrasound. He or she may also order these tests if a lump was discovered during a physical exam.
This form of breast biopsy—called stereotactic—is often used when small growths or accumulations of calcium are detected on a mammogram, but do not appear on an ultrasound.
A stereotactic breast biopsy is a relatively simple and low-risk procedure. However, it does carry these risks:
- altered appearance of your breast, depending on the size of the tissue removed
- bruising and swelling of the breast
- infection of the biopsy site
- soreness at the injection site
If you follow your doctor’s instructions on how to care for your wound, you will greatly reduce your risk of infection.
If you are pregnant or concerned you may be pregnant, radiation from the X-rays may be harmful to your unborn child. Be sure to tell your doctor so alternative biopsy methods can be considered.
Complications from a biopsy are rare. The risks associated with the procedure are outweighed by the benefits of having potentially cancerous lumps inspected. Remember, the quicker breast cancer is detected, the faster treatment can begin.
Before your breast biopsy, tell your doctor about any allergies you have, especially any history of allergic reactions to anesthesia. Also be sure to mention any medications you may be taking—including over-the-counter drugs such as aspirin or supplements—because these may cause blood thinning.
During the test, you could be lying on your stomach for up to an hour. Talk to your doctor if you are concerned that will be a problem for you.
You’ll be asked to change into a hospital gown. You should avoid using moisturizer on your breast and remove all jewelry and any body piercings before the biopsy.
You might be given a cold pack after the procedure to help with pain and inflammation. Wear a bra to help keep the cold pack in place.
Before the procedure begins, you will have to undress from the waist up.
Your stereotactic biopsy will take place in an operating room. You’ll lie facedown on a padded table with a hole in it. Your breast will drop into this hole.
The table is raised several feet in the air so your radiologist can access your breast though the hole in the table. He or she will then use two plates to firmly compress your breast. This allows them to get X-ray pictures of your breast and identify the abnormalities in the breast tissue.
This part of the procedure can take anywhere from 30 minutes to an hour.
After the proper images are taken, your breast will be numbed with anesthesia. Then, a surgeon will make a small incision—typically about a quarter of an inch—in your breast.
A sample of breast tissue will be taken through the incision using a needle or a probe attached to a vacuum. Several small tissue samples will be removed and sent to a laboratory for testing.
After the samples are taken, the surgeon will stitch the incision wound closed and bandage it. A small metal clip or needle may be left in the place where the biopsy was done, so it can easily be detected again if more testing is needed.
You will be able to go home after your stereotactic breast biopsy.
The samples of your tissue will be sent to a laboratory. It may take up to a week for them to be properly analyzed.
You will be asked to care for the incision wound. This includes keeping it clean and changing the bandages. Your doctor will instruct you how to properly care for wound.
If you develop a fever over 100 °F, or experience redness, warmth, or discharge from the site, you should contact your doctor. These are all signs of infection.
Your test results can come back as benign (non-cancerous), pre-cancerous, or cancerous.
If the sample was cancerous, the biopsy results will also give the type of cancer. Types of breast cancer that can be detected include:
- ductal carcinoma: cancer of the breast ducts
- inflammatory breast cancer: a rare form that makes the skin of the breast appear infected
- lobular carcinoma: cancer of the lobules, or the glands that produce milk
- Paget’s disease: a rare cancer that affects the nipples
Your doctor will use the type of cancer and other information from the biopsy to help plan your treatment. This may include lumpectomy (the surgical removal of the tumor), radiation, chemotherapy, hormone therapy, or mastectomy (partial or full removal of the breast).
However, there are several non-cancerous conditions that can also cause lumps in the breast. They include:
- adenofibroma: a benign tumor of the breast tissue
- fibrocystic breast disease: painful, lumpy breasts caused by hormone changes
- intraductal papilloma: small, benign tumors of the milk ducts
- mammary fat necrosis: lumps formed by bruised, dead, or injured fat tissue
Once your results are available, your doctor will explain them thoroughly to you and discuss any necessary treatment. Make sure all of your questions are answered before you leave his or her office.