Understanding Stereotactic Breast Biopsy
      Mammography has allowed us to detect breast cancer much earlier, with significantly improved outcomes. Most mammographic abnormalities are either followed closely with serial mammograms or removed surgically. During the last ten years, a new technology has become available. This is stereotactic image-guided surgery, a technique by which tissue can be obtained from a mammographic abnormality to determine the presence of cancer. This is a far less invasive way to obtain the tissue needed for diagnosis. Stereotactic incisional biopsy (MammatomeŽ) is associated with less recovery time and scarring.

How is the biopsy preformed ?
      After you are placed in a gown, you will be asked to lie face down on the procedure table. It is important to be as comfortable as possible. Your breast will be placed through a round opening in the table. The table is elevated so that Dr. Walker can work from below. Your breast will be compressed less than as during a mammogram. A confirming X-ray will be taken to insure that the abnormality is in the appropriate position. Following this, two mammograms will be taken from different angles. With the help of a computer, an exact position of the lesion is determined for the guidance of the biopsy device. Using this information, Dr. Walker will position the biopsy device for the correct point of entry. The skin is "numbed" with a local anesthetic. You may feel a slight stinging.

Removing the Samples
      After the local anesthetic has taken effect, a biopsy device is inserted into your breast through a tiny incision. Another set of X-rays will be taken to assess proper placement. Once this is confirmed, the surgeon will ask you to hold very still while the device is positioned exactly AT the lesion. Twelve small samples are taken "around the clock" through the same skin entry point. Gentle pressure will then be applied for about five to ten minutes and a small bandage will be applied.

What preparation is required ?
      If you are on blood thinning medication or take aspirin daily, these should be eliminated about one week prior to biopsy, unless your surgeon informs you otherwise. On the morning of surgery you should eat a light breakfast and take your usual morning medications. You should wear a loose two-piece outfit and preferably a comfortable and loose bra. Don't apply any talcum powder or deodorant to the breast or underarm on the side which is to be biopsied. If, because of heart problems you must take antibiotics for dental work or surgery, that would apply here also. If you need a prescription for those, it will be given to you by our office a few days in advance.

How long will it take, will it hurt, and can I drive myself home ?
      Generally the entire visit ,including the procedure itself, should take about one hour. The actual procedure should be completed within 30-40 minutes. There is a minimal amount of discomfort associated with the injection of the local anesthetic. Usually there is momentary stinging as each biopsy core is taken. You will not be allowed to drive for 6 hours, and therefore, someone will need to take you home.

May I resume normal activities right away ?
      Most women feel fine after the procedure and return to their normal routine right away. We recommend that strenuous exercise should be avoided for at least 24 hours. If possible, it is not a bad idea to go home after the procedure and simply relax. It is not essential, however.

When will we get the results ?
      We will send the tissue samples to a pathologist who will examine it under a microscope. We should obtain a report within 2 - 3 working days. We will have you come to our office to discuss your results.

Does a negative biopsy mean no further follow-up ?
      No. It is very important to continue follow-up for any abnormality on a mammogram. Your surgeon will arrange a follow-up office visit and a repeat mammogram, which would be taken within 6 months. Subsequent mammograms will be needed on a regular basis. A single negative biopsy, by either the stereotactic or the traditional approach, provides important and reassuring information. However, long-term follow-up remains essential.

What if I have more questions ?
      It is important that all of your questions are answered and that you have all of the information which you need. If you have additional questions, please contact the Center at 410-836-0909 or 410-893-0433.