Breast Biopsy Modalities

The past decade has seen dramatic improvements in breast biopsies, giving physicians and patients new choices in breast biopsy procedures.

Most women can now receive an accurate breast biopsy diagnosis without the need for an open surgical procedure1.

Breast biopsies can be performed under multiple imaging modalities. Knowing your options and discussing them with your doctor may help you gain a definitive diagnosis while minimizing pain, scarring and recovery time.

Image Guidance

Minimally invasive biopsies, such as those conducted with Mammotome biopsy devices, core needle biopsy, and fine needle aspiration (FNA), use computer-generated images to locate breast abnormalities. By accurately pinpointing and mapping the area to be biopsied, physicians can gather tissue samples (or cellular material) without making large incisions.

There are three methods used for producing images in minimally invasive breast biopsies: stereotactic x-ray, ultrasound and magnetic resonance (MR) imaging. Stereotactic biopsies use mammography (x-rays); ultrasound biopsies use high-frequency sound waves; and MR biopsies use powerful magnets and radio waves to locate breast abnormalities.

Stereotactic Biopsies

In a minimally invasive breast biopsy using stereotactic imaging, a patient lies face down on a special table with her breast protruding through a hole in the table’s surface, or the patient sits up on a specially designed biopsy table. The breast is lightly compressed to immobilize it throughout the biopsy procedure. The table is connected to a computer that produces detailed x-ray images of the abnormality to be biopsied. Using these images, the doctor guides a special sampling device (for example, a Mammotome biopsy probe) to collect tissue specimens.

Ultrasound Biopsies

Minimally invasive breast biopsies using ultrasound imaging are performed on patients in a reclined position. Using a hand-held transducer, a doctor will move the device back and forth across the breast to generate clear images of the abnormal breast tissue. While viewing the images on a computer monitor, the doctor will guide a small probe into the breast to retrieve sample tissue specimens.

MRI Biopsies

Breast MRI biopsies differ only slightly from traditional needle biopsies. Although the needle looks the same, it is specialized and made of a different material, such as titanium, so it is compatible with MRI and can be used in an MRI suite.

The increased ability to detect cancerous breast lesions with MRI and biopsy them during the test is especially valuable for patients at high risk for breast cancer.

1. https://www.ncbi.nlm.nih.gov/books/NBK45596/