Stereotactic needle biopsy
Stereotactic needle biopsy is a minimally invasive outpatient procedure primarily used to determine the presence of cancerous lesions in the breast. This technique utilizes X-ray imaging to create a three-dimensional view of the breast, allowing for precise localization of the suspicious area. Typically performed by a radiologist or breast surgeon, the procedure begins with the patient lying prone on a specialized table, which facilitates access to the affected breast. After administering a topical anesthetic and ensuring sterile conditions, the doctor uses computer guidance to insert a needle into the lesion, collecting tissue samples for analysis.
The procedure is prompted by abnormal findings from mammograms, ultrasounds, or MRIs, with results typically available within two to five days. While risks such as infection and bleeding exist, they are considered minimal. If the biopsy results indicate benign tissue, no further action may be needed; however, a surgical biopsy may be required if cancer is detected. Overall, stereotactic needle biopsy provides a crucial tool for early cancer detection, enabling timely and appropriate treatment options.
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Subject Terms
Stereotactic needle biopsy
ALSO KNOWN AS: Breast biopsy, image-guided biopsy
DEFINITION: Stereotactic needle biopsy is an outpatient procedure, usually performed by a radiologist or breast surgeon, in which a biopsy is obtained following X-ray tests for cancer in the breast. A stereo pair of the breasts to be biopsied is generated using an X-ray tube at two slightly different positions, and the images are combined with a computer, much the way the eyes capture the same object with two slightly different images that the brain then unites to form the final three-dimensional image.
Cancer diagnosed:Breast cancer
Why performed: Stereotactic needle biopsy is used to determine whether a suspicious lesion is cancer. A doctor may order a stereotactic needle biopsy if the results of a patient’s mammogram, breast ultrasound, or magnetic resonance imagining (MRI) are abnormal.
Patient preparation: Before stereotactic needle biopsy, a sterile technique is observed, and a topical anesthetic is administered.
Steps of the procedure: The doctor obtains the informed consent of the patient and verifies the correct breast to be biopsied. A stereotable is used, whereby the patient is prone with the affected breast hanging down through an opening in the table. A stereo pair of the breasts is generated, and the relative shift in the lesion’s position between the two X-ray pictures, called parallax shift, allows the computer to determine the exact location of the lesion in three dimensions.
The skin surface of the breast to be biopsied is cleaned with antiseptic, and local anesthetic is given. The needle is inserted into the breast lesion through a tiny nick in the skin under computer guidance. Several samples of the lesion are then obtained. Adhesive skin closures (Steri-Strips) are applied to close the nick in the skin, and a sterile dressing is then applied. The samples are labeled and sent to pathology.
After the procedure: The patient is given discharge instructions, including to avoid the use of aspirin or ibuprofen and to instead take acetaminophen (Tylenol) for pain, to apply cold compresses over the biopsy site that evening to reduce swelling, to avoid exercise for at least twenty-four hours, and to monitor for any sign of fever or infection.
Risks: The risks of this procedure, although minimal, include infection, bleeding at the biopsy site, and bruising and/or scarring. Still, sterotactic needle biopsy is a minimally invasive procedure that can be performed on an outpatient basis in under an hour.
Results: The pathology results are usually available within two to five days postprocedure, and if the lesion is benign, then no further workup is usually necessary. If the lesion is cancer, however, an open surgical biopsy may then be necessary to ensure complete removal.
Bibliography
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“Breast Biopsy - Stereotactic.” MedlinePlus, 11 Mar. 2023, medlineplus.gov/ency/article/007433.htm. Accessed 23 June 2024.
“Breast Biopsy (X-ray guided - Stereotactic).” Radiologyinfo.org, www.radiologyinfo.org/en/info/breastbixr. Accessed 23 June 2024.
“Stereotactic Biopsy of the Breast.” Harvard Health Publishing, 6 Dec. 2019, www.health.harvard.edu/cancer/stereotactic-biopsy-of-the-breast-a-to-z. Accessed 23 June 2024.
“Stereotactic Breast Biopsy.” Cleveland Clinic, 4 Oct. 2022, my.clevelandclinic.org/health/diagnostics/24256-stereotactic-breast-biopsy. Accessed 23 June 2024.
“Stereotactic Core Biopsy - UCSF Radiology.” UCSF Department of Radiology & Biomedical Imaging, radiology.ucsf.edu/patient-care/prepare/stereotactic-core-biopsy. Accessed 23 June 2024.