Image guided biopsy
For an image guided biopsy, a needle is used to remove small pieces of tissue from an area of concern in the breast under image guidance. The tissue is then processed by the pathology team. Breast needle biopsies can be done with stereotactic, ultrasound or MRI guidance.
This type of biopsy is used to sample calcifications or lesions only seen on a mammogram. This can be performed in one of two ways:
- Laying on your stomach on a padded table with the head turned to the side. The table has a round opening that allows your breast to hang below the table and out of your view. Your breast is held in place from a device below.
- Sitting up in a chair with your breast compressed by a device in front of you.
You and your radiologist will decide what approach is better for you based on your images and other considerations.
During the procedure, the area of concern is localized using X-ray guidance. The skin is cleaned and numbed with local anesthesia. A small skin incision, so small it does not require stitches, is made. The needle is advanced to the area of concern by the radiologist and samples are taken. A small marking clip is left at the site of the biopsy so that it can easily be found again if needed.
Ultrasound guided biopsy
This type of biopsy is done with you laying on an ultrasound table. The breast is cleaned and numbed using local anesthesia. A small skin incision, so small it does not require stitches, is made. Using ultrasound guidance, the radiologist will advance the biopsy needle to the site of concern to take samples. The samples are then sent to pathology. A small marking clip will be left at the site of the biopsy so that it can easily be found again if needed.
MRI guided biopsy
These are done on areas of concern that can only be seen using an MRI. This procedure is performed by radiologists from Jane Brattain Breast Center at Methodist Hospital.
First, an IV is started so that contrast can be given. You lie on your stomach so that your breast hangs down to be compressed. Images are taken with and without contrast. Your skin will be cleaned and numbed with local anesthesia. The biopsy device is positioned using the images as a guide. The radiologist takes several samples and a small marking clip will be left at the site of the biopsy so that it can easily be found again if needed. A gentle mammogram is done at the end of the procedure to make sure the clip is in the correct position.