Following a mammogram and/or ultrasound, the radiologist may recommend a breast biopsy. If indicated, this procedure is scheduled by the technologists immediately following the patient’s diagnostic workup.
The three types of needle biopsies performed in the Breast Imaging Center at UMC are:
- Ultrasound-guided breast biopsy – Recommended for patients with breast lumps that are identified on ultrasound or mammogram. The technician and radiologist identify the abnormal area under ultrasound, inject numbing medication, and insert a needle to take several samples of the abnormal area.
- Stereotactic breast biopsy –Recommended when there are clusters of micro-calcifications or other abnormal areas identified on mammogram. Patients lie on their stomach for this procedure and the breast tissue is directed through an opening in the table. Using X-rays and computerized assistance, the abnormal area is identified, numbing medicine is injected, and a needle is inserted to take several samples of the abnormal area.
- MRI-guided breast biopsy –An MRI-guided breast biopsy is most helpful when MRI imaging shows a breast abnormality, such as a suspicious mass not identified by other imaging techniques, an area of distortion, or an area of abnormal tissue change. Patients lie on their stomach for this procedure and both breasts are directed through an opening in the table. Magnetic resonance, or MR-guided breast biopsies use a powerful magnetic field, radio waves and a computer to help locate a breast lump or abnormality. Once the abnormal area is identified, numbing medicine is injected, and a needle is inserted to take several samples of the abnormal area.
Most health care providers will first try a needle biopsy in order to determine the breast change, but in some instances, a referral for a surgical biopsy may be needed.
Needle localizations (also called wire localizations) are procedures done before breast cancer surgery to find where the breast abnormality is, so the surgeon knows exactly what tissue to take out. This procedure is done under mammogram or ultrasound guidance. During this procedure, the abnormal area is identified, numbing medicine is injected, and then a needle is inserted and a ﬁne wire is placed as close as possible to the area of concern. With the wire in place, the surgeon will know where the tissue is that needs to come out.