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| Breast Biopsy Sometimes the only way to tell what a finding on a breast imaging study represents is to obtain tissue for the pathologist to analyze. In the not so distant past, biopsies almost exclusively obtained surgically. However, many cases can be resolved with non-surgical interventional needle biopsies and thus avoid surgery. These needle biopsies are performed with imaging guidance by either using ultrasound or special mammography equipment called stereotactic biopsy. The advantages of these methods include the avoidance of a surgical procedure, obtaining a diagnosis quickly, less subsequent breast pain and swelling, and no scarring. Since between approximately 60 - 80% of breast biopsies have benign outcomes, these needle biopsies offer distinct advantages in cases where they are applicable. In cases where cancer is diagnosed, a fully planned cancer surgical approach can then be performed. This gives the surgeon the advantage of knowing ahead of time, so that many repeat surgeries can be avoided. At Saint John's Health Center's Joyce Eisenberg Keefer Breast Center, Stereotactic biopsies are performed using a digital prone unit. This unit offers the patient the advantage of laying on her stomach with the breast positioned through an opening in the table. Digital images with computer guidance help localize the area of interest so the breast imaging interventional radiologist can perform the needle biopsy. Most stereotactic biopsies are done for calcifications deemed abnormal by the interpreting mammographer, but other abnormalities can also be sampled using this piece of equipment. When lesions are quite small, they can be virtually entirely removed with a needle biopsy. Ultrasound guided needle biopsies are done for a palpable lumps which were evaluated by mammography and ultrasound. Advantages of using ultrasound for needle biopsy of breast lesions include: the procedures are generally completed more rapidly, the radiologist can actually watch the biopsy needle go into the abnormality giving confidence that the proper material will be sent to the pathologist for analysis, and typically fewer biopsy samples need be obtained. Should a lump prove to be a cyst, ultrasound can also be used for cyst aspirations. |
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