Lumps or masses in the breast are not unusual, and most of them
are not cancerous. Some breast masses can be felt during a breast exam. Others
are detectable only by mammogram (breast X-ray). How a mass is detected does not
determine whether it is cancerous. Breast lumps should be evaluated by a
physician experienced in diagnosing breast cancer.
When a breast biopsy is recommended for an abnormal mammogram
finding, patients may opt for a minimally invasive alternative to surgery known
as image-guided core needle biopsy. This is a tissue sampling technique that
does not require surgery.
How is image-guided core needle biopsy performed?
The needle biopsy can be performed using ultrasonic or stereotactic guidance.
During the procedure using stereotactic guidance, the
patient lies on her abdomen on a specially designed exam table. An opening in
the table allows access to the breast. The table is raised, and the biopsy is
done from below the table.
The area to be biopsied is centered in the window of a specially
designed compression paddle. Mammogram films are taken so the radiologist can
examine the breast tissue to be biopsied. These films are called scout films.
During the procedure using ultrasonic guidance, the
patient lies on her back on the exam table. The ultrasound probe is then used to
identify the lump.
For either stereotactic or ultrasound guidance, a local
anesthetic is used. The radiologist makes a small opening in the skin. A sterile
biopsy needle is placed perpendicular to the breast tissue area to be biopsied.
Computerized pictures help confirm the exact needle placement using digital
imaging. Tissue samples are taken through the needle. It is common to take
multiple tissue samples (about three to five). This part of the biopsy takes
approximately 15 to 20 minutes. Upon completion, sterile strips and a small
adhesive bandage are applied to the skin. The entire procedure takes
approximately an hour. Results are usually available in three to five working days.
What are the benefits of image-guided core needle biopsy?
- Minimal scarring instead of a large incision
- Reduced post-procedural pain
- Minimal bleeding
- Potentially lower hospital costs
- Immediate return to work
- Shorter recovery time and immediate resumption of daily activities
- Less wait time to have procedure performed
How safe is image-guided core needle biopsy?
This procedure is as safe as "open" surgery when performed by specialists in
this field. It is more commonly performed today than it previously was.