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Stereotactic Breast Biopsy

Mark P. Bowes, PhD

*Medical Writer, Portland, Oregon.
Address correspondence to: Mark P. Bowes, PhD, Medical Writer, 7135 SE 18th Avenue, Portland, OR 97202. E-mail: mpbowes@gmail.com.

Disclosure Statement: Dr Bowes reports having no financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Although the use of mammography for breast cancer screening reduces the risk of breast cancer mortality, most abnormalities that are identified on screening mammograms are not breast cancer. Breast biopsy is essential for cancer diagnosis and treatment selection, and is indicated for approximately 2% of women who undergo screening mammography. Surgical biopsy entails removal of the suspect lesion identified on mammography, and for many years was the only option for obtaining adequate tissue specimens for histologic analysis. Over the last 2 decades, several percutaneous biopsy options have become available. Percutaneous biopsy provides a less invasive alternative to surgical biopsy, with a high rate of accuracy and good safety and patient acceptability. Stereotactic biopsy uses a pair of digital or analog mammography images obtained from 30 degrees apart to calculate the depth of a target lesion below the surface. The stereotactic method may be used with a variety of biopsy devices and needle sizes to quickly obtain tissue samples for histologic assessment. Successful stereotactic biopsy technique requires the consideration of several factors, including the patient's previous mammography findings, the location of the target lesion within the breast, correct positioning of scout images and images obtained before and after deployment of the biopsy device, and ensuring that there is a sufficient margin of tissue between the tip of the biopsy device and the back of the breast. Failure to correctly position and deploy the biopsy device may result in underestimating the extent of the patient's disease, or it may necessitate additional imaging sessions or surgical biopsy. Stereotactic biopsy is generally safe and well tolerated by patients, with a low incidence of serious adverse outcomes.

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