Minimally Invasive Breast Biopsies

When a Breast biopsy is recommended to test for breast cancer, patients may be able to choose a minimally invasive procedure known as image-guided needle biopsy. This is a technique that does not require surgery. Most of the time, the radiologist performs this type of biopsy.

The needle breast biopsy can be performed using ultrasound or stereotactic guidance. Stereotactic refers to the use of stereo images, pictures of the breast taken from different angles, to determine the precise location of the abnormal tissue.

When stereotactic guidance is used, 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. This procedure may also be done with the patient sitting upright in a chair, particularly for those who are unable to lie on their abdomen for any reason. When ultrasound guidance is used, the patient lies on her back on the exam table.

The area that needs to be tested 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.
After giving a local anesthetic, the radiologist makes a small opening in the skin. A sterile biopsy needle is placed into the abnormal breast tissue. Computerized pictures help confirm the exact needle placement using digital imaging.

Tissue samples are taken through the needle. It is common to take about three to five tissue samples. There are a number of biopsy instruments that can be utilized to obtain the tissue sample. They include core biopsy which uses a needle to obtain a piece of tissue about 1/16 inch across and ½ inch long, and a vacuum assisted needle biopsy device (VAD), which uses vacuum suction to obtain a tissue sample. This tissue is then examined under the microscope to look for cancer cells. This part of the biopsy takes approximately 15 minutes upon completion; sterile strips and a small adhesive bandage are applied to the skin.
The entire procedure takes approximately 30 minutes to an hour. Results are usually available in three to five working days.