Stereotactic Breast Biopsy: Purpose, Risks, and Results

A stereotactic breast biopsy is a procedure that takes a tissue sample from a suspicious area in the breast. Your healthcare provider commonly suggests this biopsy when you receive an abnormal result in other breast imaging tests like mammograms, ultrasounds, or an MRI scan.

Using mammography and computer guidance, a radiologist (a doctor who specializes in medical imaging) can accurately locate and remove tissue from the area of concern to rule out or diagnose breast cancer.

The purpose of a stereotactic breast biopsy is to serve as a follow-up exam after you receive an abnormal result on another breast imaging test, such as a mammogram. You may need this test for several reasons, such as if your provider notices:

• Suspicious lumps or masses
• Microcalcifications (tiny deposits of calcium) in the breast tissue that can sometimes be a sign of cancer
• Changes in breast tissue structure or appearance that need further investigation
• A new mass or calcium deposit in a former surgery site

The results of a stereotactic breast biopsy provide detailed information about your breast tissue, such as if the area is benign (non-cancerous) or malignant (cancerous). This information is crucial for determining a diagnosis of breast cancer, the type of breast cancer you have, how aggressive the cancer is, and what treatment is most beneficial for you.

There are two main types of stereotactic breast biopsy procedures, which vary based on the technique and tools used to obtain the tissue sample. These include:

• Core needle biopsy: This is the most common type of stereotactic breast biopsy. A radiologist uses a hollow needle to remove small tissue cores from the suspicious area. The procedure is minimally invasive and usually performed under local anesthesia.
• Vacuum-assisted biopsy: This type of biopsy uses a vacuum-powered instrument to collect multiple tissue samples and larger amounts of tissue with just a single needle insertion. Generally, this procedure can offer a more accurate diagnosis than a core needle biopsy. Like a core needle biopsy, this type is also minimally invasive and uses local anesthesia.

Both types of stereotactic breast biopsies use mammography and computer guidance to locate and sample the area of concern precisely. The choice between a core needle biopsy and a vacuum-assisted biopsy depends on factors such as the size and location of the abnormality, as well as your medical history and preferences.

If your provider recommends a stereotactic breast biopsy, you’ll usually set up an appointment with the imaging department of your local hospital, a specialized radiology clinic, or an oncology office equipped with the necessary imaging technology. Your healthcare provider should give you detailed notes on how to prepare. However, some common recommendations may include the following:

• Avoid wearing jewelry or metal accessories, as these can interfere with imaging.
• Inform your radiologist about all medications you are taking before the appointment, as they might advise you to stop taking certain medications temporarily.
• Tell your provider if you may be pregnant, as the test may not be safe for you.
• Do not use perfume, powder, deodorant, or lotion before your procedure.

Getting tested for breast cancer can be a worrisome experience. Knowing what to expect during and after the test can help calm any anxiety you may have.

During the Test

When you go in for the exam, your healthcare team will ask you to lie face down, on your side, or sit on a special table designed for the procedure. Your provider will compress your breast between two plates to immobilize it and ensure they are targeting the correct area of concern. This can feel uncomfortable but is often necessary for accuracy. If you experience significant pain, let your provider know so they can make any adjustments, if possible.

There are two parts of the procedure: imaging and biopsy. You can expect the entire procedure to last about an hour, and you’ll be awake during the entire test.

Imaging and Localization

Your radiologist will take several mammographic images to identify the exact location of the abnormality. Using computer software, your radiologist will then pinpoint the exact coordinates of the breast that require a biopsy.

Biopsy

Once your radiologist figures out where in your breast they need to collect a tissue sample from, the biopsy portion of the procedure will begin. They’ll administer local anesthesia to numb the breast tissue, which helps you remain comfortable during the procedure. Then, your radiologist will make a small incision in your breast and insert a biopsy needle through to take a sample of your tissue.

If you’re receiving a core needle biopsy, your radiologist will take multiple small tissue cores from your breast. However, if your provider recommends a vacuum-assisted biopsy, the instrument will collect larger tissue samples at once.

In some cases, your radiologist may take additional post-biopsy mammogram images to confirm that they removed tissue from the correct breast area. They may also place a tiny marker on the biopsy site to help locate the area in future imaging scans, should you need them.

After the Test

Once your test is complete, your healthcare team will compress and bandage the biopsy site to minimize bleeding. You’ll also need to stay in an observation room for a short period so your providers can ensure that you’re not experiencing any immediate side effects or complications.

Breast biopsies are usually outpatient procedures, meaning you can go home on the same day. If you’re getting a biopsy, it can help to have someone who can drop you off and pick you up.

When you get home, your provider will advise you to avoid strenuous activities for the rest of the day. If you’re experiencing discomfort, they may recommend taking over-the-counter pain relievers. Ice packs may also help reduce swelling and bruising on your breast. These symptoms should be minimal, however. If you experience excessive swelling, bleeding, or redness on the breast, it’s important to tell your healthcare provider immediately.

While a stereotactic breast biopsy is generally safe, there are some potential risks and complications associated with the procedure. These risks are typically very rare, but it’s still important to be aware of the following:

• Bleeding at the biopsy site
• Extreme discomfort
• Skin infection
• Cancer from radiation exposure during the imaging test
• Lung collapse, if the needle passes through the chest wall

A biopsy may not provide a definitive answer to explain an abnormality from a previous mammogram. This may require you to do additional testing.

After the exam is complete, your healthcare team will set up a follow-up appointment to discuss your results. When the tissue sample is sent to the lab, a pathologist (a doctor who studies fluids, tissues, and organs) examines the biopsied tissue to make the final diagnosis.

Generally, it can take up to a week to receive your test results. Your provider will reach out via phone call or online message portal to let you know when your results are ready for review.

Interpreting Your Results

The results of a stereotactic breast biopsy can provide critical information about the nature of a breast abnormality. When you get your results back, they’ll either be positive, negative, or inconclusive. Here’s what each result means:

• Positive: If the biopsy results are positive, this means that cancer cells or another abnormality were detected. You may need a second test to confirm these findings. If you receive a diagnosis, your provider will then also discuss treatment options for breast cancer, which may include surgery, chemotherapy, or radiation, among others.
• Negative: A negative result generally means no signs of cancer or other significant abnormalities were found. However, this does not always mean you’re completely in the clear. Your healthcare provider might suggest further imaging tests, repeated biopsies, or continued monitoring, especially if symptoms persist or if you have other risk factors for breast cancer.
• Inconclusive: An inconclusive result means that the pathologist could not detect the presence of cancer cells, but they also couldn’t rule out breast cancer. If the biopsy results do not give a clear diagnosis, your healthcare provider will likely order additional tests. These might include other imaging tests like an MRI or ultrasound, lab tests, or blood tests. In some cases, a repeat biopsy might also be necessary.

A stereotactic breast biopsy is a procedure that helps detect abnormalities in the breast after you receive alarming results from a mammogram. This exam uses advanced imaging techniques and computer technology to take a sample out of a concerning area of your breast tissue to test it for cancer.

The procedure takes about an hour and you’ll likely receive results within a week. Results can be positive (cancer is present), negative (cancer is not present), or inconclusive (unsure whether there is cancer). Based on your results, your provider can offer next steps to either treat the condition, recommend further testing, or monitor you from time to time.