Breast Biopsy

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During the Breast Biopsy Procedure Performed by Hill Medical

How is breast biopsy performed?

Breast Biopsy using Stereotactic Guidance

Once checked in and registered, you will be taken to a dressing room, where you will change into a patient gown. A locker is available to secure personal items. You will then wait comfortably until the technologist escorts you to the Stereotactic Biospy room.

The technologist will review the procedure with you, answer any questions, and have you sign a consent form.

In the biopsy room, you will lie on your stomach on a special table with a hole through which the breast is placed and aligned with the imaging unit beneath. You can expect to be in the biopsy room for an hour or longer and you’ll be awake throughout the procedure. The physician performing the procedure will have studied your mammogram to become familiar with the location of the abnormal tissue in your breast. A confirming x-ray is taken to insure that the breast is positioned correctly. The skin on your breast will be cleansed; then a local anesthetic is injected with a very fine needle. You may feel a slight sting. Your breast will be slightly compressed, just as in a mammogram.

A small nick is made in your skin and a thin, hollow needle is inserted through the nick. Because of the local anesthetic, most patients report only a small amount of discomfort. The doctor will use the computerized imaging system to precisely guide the needle to the biopsy area where several small samples will be taken. After the needle is removed, a sterile gauze bandage is placed on the skin to prevent bleeding. An ice pack will also be applied. This procedure requires no stitches.

Before leaving the office, you'll be given instructions for biopsy aftercare that are specific to your individual needs. Your breast should heal quickly, leaving almost no sign of the procedure.

Tissue samples are then sent to the pathology department for processing, interpretation and reporting.

How long with the Stereotactic Biopsy take?

Generally the biopsy is completed in less than an hour. It is not necessary to close the tiny skin incision with sutures; a small compression dressing will do. Most patients are able to resume their usual activities later the same day.

Ultrasound-guided breast biopsy

Once checked in and registered, you will be taken to a dressing room, where you will change into a patient gown. A locker is available to secure personal items. You will then wait comfortably until the technologist escorts you to the ultrasound examination room.

The technologist will review the procedure with you, answer any questions, and have you sign a consent form.

During an Ultrasound-guided breast biopsy, with the patient lying on her back or turned slightly to the side, the ultrasound probe is used to locate the lesion. Enough local anesthesia is injected to be sure that you will feel no discomfort during the procedure. Ultrasound is also used to guide the injection of an anesthetic along the route to the lesion and about the mass. A very small nick is made in the skin at the site where the biopsy needle is to be inserted.

The radiologist, constantly monitoring the lesion site with the ultrasound probe, guides a hollow core breast biopsy needle or the vacuum-assisted needle directly into the mass and obtains specimens. Usually at least four samples are taken. In some cases it may be difficult to visualize the needle in the breast tissue and considerable skill is needed to coordinate movements of the ultrasound transducer with needle insertion. If the lesion is nearly or completely removed during the biopsy procedure, a clip is placed where the lesion was located to ensure that the site can be easily located for additional surgery if the lesion proves to be malignant.

Before leaving the office, you'll be given instructions for biopsy aftercare that are specific to your individual needs. Your breast should heal quickly, leaving almost no sign of the procedure.

Tissue samples are then sent to the pathology department for processing, interpretation and reporting.

How long with the Ultrasound-Guided Biopsy take?

Generally the biopsy is completed in less than a half hour. It is not necessary to close the tiny skin incision with sutures; a small compression dressing will do. Most patients are able to resume their usual activities later the same day.

MRI-Guided Breast Biopsy

Once checked in and registered, you will be taken to a dressing room, where you will change into a patient gown. A locker is available to secure personal items. You will then wait comfortably until the technologist escorts you to the MRI room.

Please do not bring hearing aids, credit cards, jewelry and watches, eyeglasses, pens, removable dental work, and anything that's magnetic near the MRI machine. You may lock them in the locker that is provided for your convenience.

The technologist will review the procedure with you, answer any questions, and have you sign a consent form.

You will lie face down on an exam table and the affected breast or breasts will be positioned into openings in the table.

A technologist will insert an intravenous (IV) line into a vein in your hand or arm and the contrast material gadolinium will be given intravenously.

You will lie on your stomach on a padded table with the breast suspended through an opening. An MRI scan of the breast will be done to locate the biopsy area. The radiologist will perform the biopsy from the side; the affected breast will be slightly compressed during the procedure. Additional images may be taken after the procedure.

Your breast will be gently compressed between two compression plates (similar to those used in a diagnostic MRI exam), one of which is marked with a grid structure. Using computer software, the radiologist measures the position of the lesion with respect to the grid and calculates the position and depth of the needle placement.

A local anesthetic will be injected into the breast to numb it. A very small nick is made in the skin at the site where the biopsy needle is to be inserted. The radiologist then inserts the needle, advances it to the location of the abnormality and MR imaging is performed to verify its position. You will be moved out of the scanner for the radiologist to place the needle in the breast, and then be moved back in to image the breast.

Tissue samples are then removed using one of following methods:

In a core needle biopsy, the automated mechanism is activated, moving the needle forward and filling the needle trough, or shallow receptacle, with 'cores' of breast tissue. The outer sheath instantly moves forward to cut the tissue and keep it in the trough. This process is repeated three to six times.

With a vacuum-assisted device (VAD), vacuum pressure is used to pull tissue from the breast through the needle into the sampling chamber. Without withdrawing and reinserting the needle, it rotates positions and collects additional samples. Typically, six to eight samples of tissue are collected from around the lesion.

After this sampling, the needle will be removed.

If a surgical biopsy is being performed, a wire is inserted into the suspicious area as a guide for the surgeon.

A small marker may be placed at the site so that it can be located in the future if necessary.

Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed.

A mammogram may be performed to confirm that the marker is in the proper position.

Before leaving the office, you'll be given instructions for biopsy aftercare that are specific to your individual needs. Your breast should heal quickly, leaving almost no sign of the procedure.

Tissue samples are then sent to the pathology department for processing, interpretation and reporting.

How long with the MRI-Guided Biopsy take?

Generally the biopsy is completed in 1 - 2 hours. It is not necessary to close the tiny skin incision with sutures; a small compression dressing will do. Most patients are able to resume their usual activities later the same day.


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