Stereotactic (Mammographically Guided) Breast Biopsy

hero_affirm_breast_biopsyIn a stereotactic breast biopsy, a special mammography machine uses ionizing radiation to help guide the radiologist’s instruments to the site of the abnormal growth.

A breast biopsy is performed to remove some cells—either surgically or through a less invasive procedure involving a hollow needle—from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. Stereotactic breast biopsy is an x-ray procedure that uses multiple coordinates to precisely determine the location of a tumor or nodule so that a tissue sample may be obtained.

Image-guided needle biopsy is not designed to remove the entire lesion, but most of a very small lesion may be removed in the process of biopsy. Image-guided biopsy is performed when the abnormal area in the breast is too small to be felt, making it difficult to locate the lesion by hand (called palpation).

What to Expect

How is a fine-needle aspiration done?

Your doctor will wipe the area with rubbing alcohol or iodine. In most cases, you will receive an injection of local anesthetic to numb the area of your breast where the needle will be inserted. Your doctor will hold the lump steady with one hand and insert a thin needle (attached to a syringe) into the lump. He or she may move the needle in and out of the area to make sure to get enough tissue or fluid for the biopsy. Then he or she pulls on the plunger of the syringe to remove the tissue or fluid. The process takes a few seconds to a few minutes.

If the doctor cannot easily feel the mass, you may have an imaging test, such as a CT scan, ultrasound test, magnetic resonance imaging (MRI), or mammography to see where to put the needle. In this case, a doctor known as a radiologist may do the aspiration. If the lump is a cyst, the fluid is removed, and the lump usually goes away.

How will it feel?

If you receive a local anesthetic, you may feel a brief sting when it is injected. You also may feel some pressure when the biopsy needle is inserted. The amount of discomfort will depend on how much pain you feel from needles, the part of your body involved, and the skill of the doctor. The site of the fine-needle aspiration may be sore for a couple of days, and you may have a bruise. You should be able to return to work the same day or the next day.

What happens afterward?

Your doctor will apply pressure to the aspiration site to prevent bleeding and put an adhesive bandage on it. He or she may recommend that you take a mild pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil), if you have discomfort when you get home. Keep the area dry for 24 hours.

Contact your doctor if you have bleeding, redness, swelling, or a fever of more than 100.5F over the next couple of days

How to Prepare

Do not wear lotion, perfume, deodorant, or powder the day of exam. If you are a new patient, bring previous mammogram films and report. Do not schedule one week before menstrual period. Two-piece outfits may make you feel more comfortable during the exam.

Equipment Used for This Procedure


Hologic Selenia Dimensions

The Hologic Selenia Dimensions is used for mammographies and biopsies at Sand Lake Imaging. These machines provide tomosynthesis-guided biopsy technology, and Genius 3D Mammography. Both of these lead to more accurate readings and procedures, as they produce digital 3D images rather than standard 2D images. The Hologic Selenia Dimensions also reduces exam time and cost with its use of digital imaging. With digital scans, there is no film to develop (which can get costly), and a shorter exam time provides greater comfort on the part of the patient.