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Stereotactic-guided Core Biopsy


Medical editor Marit Muri Holmen MD
Radiologist
Oslo University Hospital
Norway

General

Stereotactic-guided (X-ray guided) biopsy is indicated when ambiguous mammographic findings cannot be localized by ultrasound. This applies especially for calcium containing lesions. The examination can be done as a core biopsy (gun technique) or vacuum technique.

Cancer in situ is often manifested as calcium deposits in mammograms. The method is therefore vital for the diagnosis of this condition.

Indications

  • Diagnostic

Goal

  • To clarify whether a mammography lesion is benign or malignant, and if possible, to determine the diagnosis.

Equipment

  • Special examination table and X-ray equipment
  • Local anesthesia
  • Biopsy gun
  • Gun or vacuum apparatus with needles 14G or 10G

Preparation

If the patient is under anticoagulation treatment, biopsy gun is preferred rather than vacuum biopsy, in most cases.


Implementation

The procedure is performed aseptically.

  • The patient lies in the prone, lateral, or sitting position.
  • The breast is fixed.
  • The lesion is localized by means of X-ray images from two angles.
  • The stereotactic apparatus is mounted.
  • The breast is disinfected and local anesthetic is applied.
  • The biopsy equipment is prepared.
  • 5-6 biopsies are usually taken with slightly different positions of the needle.
  • For a calcium containing lesion, the biopsies are put on a piece of X-ray film and X-rayed to determine whether the samples are representative.
  • The area of puncture is compressed after the biopsy is taken.
  • Patients on anticoagulants are observed for 30 minutes after the procedure.  This is also done if the examination is done with a vacuum technique.
  • The incision is bandaged.

Follow-up

The patient can go home after the procedure.

The patient should:

  • Observe the incision for possible bleeding.
  • Minimize physical motion and avoid heavy lifting or sport activities the same day.
  • Wait until the following day to shower.

If pain medication is needed, paracetamol may be taken (no salicylate drugs).

The result of the test(s) is usually available after 4-7 days.


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