Your doctor may have recommended that you undergo a stereotactic or ultrasound-guided breast biopsy. Understandably, you have questions about this procedure. We want to help you understand why the procedure is necessary and what to expect. If you had additional questions please contact your doctor.

Why has my doctor requested a breast biopsy?
Probably by now your doctor has explained to you that your mammogram or ultrasound has revealed an abnormality in your breast. In the past, these abnormalities were treated in two ways. Either they were “followed” over a period of time by the doctor to see if there was a significant change, or they patient had surgery to remove the abnormality completely (surgical excisional biopsy). However, the majority of these abnormalities are benign and present no health risk. For this reason, the technology of stereotactic and ultrasound-guided breast biopsy is a less painful, less invasive way to obtain the tissue sample needed for diagnosis. This procedure requires less recovery time than an excisional biopsy, and there is no significant scarring of the breast.

Preparing for the procedure
We understand that this procedure will be uncomfortable for you but we will do everything we can to make you as comfortable as possible. The following will give you a step-by-step guideline of the procedure

• Avoid taking blood thinning agents (i.e. aspirin) for one week prior to the biopsy
• Please check with your doctor before discontinuing any prescribed medications
• You may eat and drink normally the day of the test
• Wear comfortable clothing to your procedure, including a sports bra to allow for a more comfortable fit after the dressing is applied.

Types of breast biopsies
The doctor will use one of three guidance methods for your biopsy: mammographic guidance (stereotactic), ultrasound guidance, or MR guidance.

X-Ray mammographic guidance (stereotactic)

• After checking in, you will be given a hospital gown and asked to undress from the waist up. You will then be escorted to the biopsy room.
• A mammography technologist will then take you to the Mammography room where the biopsy is performed. 
• The technologist will have you sit in a cushioned chair and make you as comfortable as possible. 
• Your breast will then be positioned and compressed similar to your mammogram. 
• Images will be taken to visualize the area to be biopsied.
• Your breast will be compressed similar to a mammogram and an x-ray will be taken to ensure that the area of the breast containing the lesion is correctly centered.
• After confirmation, two stereo x-rays will be taken. Stereo images are images of the same area from different angles. With the help of a computer, the exact positioning of the biopsy needle is determined from these stereo images.
• The doctor will then position the equipment and numb the biopsy area using a local anesthetic. You will feel a sting in your breast at the injection site.
• The doctor will then insert the biopsy needle and take another set of stereo x-rays to ensure proper placement.
• You will be asked to hold very still while the tissue samples are acquired.
• Next, a small marker will be placed in your breast to mark the site of the abnormality in case surgery is needed. The compression paddle will then be released.
• Pressure will be applied to the biopsy site for five or ten minutes to prevent bleeding.
• Two regular mammogram pictures will be taken following the procedure and a dressing is applied. Post-procedure care instructions will be given when you are ready to leave.

Ultrasound guidance
Ultrasound guided biopsies are much the same as x-ray mammographic guidance biopsies except you will be lying on your back and an ultrasound transducer will be used to locate the area to be biopsied instead of stereo images.  

MR guidance
You will be lying on your stomach.  MR images are obtained for guidance and the remainder of the procedures are much the same as stereotactic biopsies. 

Will it hurt?
The doctor uses a local anesthetic to minimize any pain. However as individuals, each of us has a slightly different pain threshold. Most patients report that they felt pressure or a slight discomfort in the biopsied area as the procedure was being done.

Will I be able to resume my normal activities right away?
Most women feel fine after the procedure and return to their normal routine right away. However, we recommend that strenuous exercise or activity be avoided for at least 48 hours. If possible, it’s not a bad idea to go home after the procedure, put your feet up, and simply relax.

What instructions should I follow after the biopsy?
Following your biopsy you will be given a list of instructions. These instructions will be specific to your individual care. The technologist will call the next day to see how you are doing and answer any questions.

When can I expect the results of my biopsy?
Tissue samples are sent to a pathologist of review. The pathologist will examine the tissue and send a report to your doctor within a few days. Your doctor will contact you to discuss your results.

What if I have more questions?
Our staff feels it is very important that your questions about biopsy procedures are answered and you have all the information you need. If you have additional questions or concerns that are not addressed on this page, please do not hesitate to contact us at 458-6900 or talk to your doctor prior to your appointment.