How stereotactic breast biopsies work

By RENEE LePERE

Feeling Fit Correspondente

There are few things more nerve-racking for a woman than hearing, "We saw something on your mammogram."

The mind races and if it hasn't gone into shock or denial, every worst-case scenario fills the head -- a positive biopsy; a rare, untreatable type that the doctors have never seen before; a mastectomy; or only a few years, months, weeks, days, minutes to live.

Take a deep breath. Treatments and survival rates continue to improve -- five-year survival rates are as high as 93 percent if the cancer is detected early, according to the American Cancer Society (ACS).

As treatments continue to improve, so does the detection technology and treatment.

One of the latest developments is the stereotactic breast -- or core needle -- biopsy, which uses digital x-rays to show breast abnormalities, according to the ACS. A computer-guided needle is used to draw, cut and collect tissue. The procedure uses only local anesthesia and is considered to be "simple, safe and painless," the ACS reports.

The biopsy takes less than an hour -- including the time it takes to conduct x-rays, according to the United States National Institutes of Health's (NIH) Library of Medicine. The actual biopsy only takes several minutes and is performed on an outpatient basis and requires no postsurgical stitches, NIH said.

Patients are asked to undress from the waist up and are usually instructed to lay face-down on a table, NIH said. The breast being tested will hang through an opening in a raised table while the doctor performs the biopsy from underneath. Occasionally, the biopsy is conducted while the patient sits in an upright position.

According to NIH, the patient should expect the following steps for the sterotactic biopsy:

•The healthcare provider will first clean the area on your breast, then will inject a numbing medicine. This may sting a little bit.

•The breast is pressed down to hold it in position during the procedure. You need to hold still while the biopsy is being performed.

•The doctor will make a very small cut on your breast over the area that needs to be biopsied.

•Using a special machine, a needle or sheath is guided to the exact location of the abnormal area. Up to six or more tissue samples are taken.

•A small metal clip or needle may be placed into the breast in the biopsy area to mark it for biopsy, if needed.

The procedure usually takes about one hour, including the time it takes for the x-rays. The actual biopsy takes only several minutes.

Once the sample has been taken, the needle or catheter is removed. Ice and pressure are applied to the biopsy site to stop any bleeding, NIH reports, and a bandage is applied to absorb any fluid.

Unlike traditional biopsies, it can collect multiple tissue samples with only one needle insertion and can place a tiny tissue maker at the biopsy location for any follow-ups, the ACS stated. The diagnosis is described as "highly accurate."

For more information, visit www.nlm.nih.gov/medlineplus/ency/article/007433.htm or www.cancer.org.