A stereotactic biopsy is a mammogram used to guide a breast biopsy. You may need a stereotactic biopsy if a previous imaging procedure found abnormal tissue that could be cancer. This procedure allows your healthcare provider to locate and remove a small tissue sample for testing without using more invasive methods like surgery.
A stereotactic breast biopsy is a special mammogram used to guide a biopsy. You may also hear this referred to as a tomosynthesis-guided biopsy. A mammogram takes low-dose X-rays of your breast that can reveal abnormal tissue or “suspicious” areas that may be cancer. During a biopsy, a healthcare provider removes the suspicious tissue so it can be tested for cancer cells. A biopsy is the only way to know if someone has cancer.
Stereotactic biopsies have been around for a little over 35 years. They’re a reliable and relatively noninvasive way to confirm whether or not a person has breast cancer.
Your healthcare provider may order a stereotactic biopsy if they find abnormal (potentially cancerous) tissue on a breast ultrasound, mammogram or MRI. While imaging can show abnormalities inside of your breast, a stereotactic biopsy can confirm whether the abnormality is a sign of cancer, a benign (noncancerous) growth or something else.
You may need a stereotactic biopsy if an imaging procedure finds:
If the tissue turns out to be cancer, a stereotactic biopsy can help your healthcare provider plan treatment.
A radiologist with special training in stereotactic breast biopsies performs the procedure. A separate provider, called a pathologist, examines the tissue sample underneath a microscope to check for cancer cells.
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Stereotactic biopsy uses a special mammography machine to locate suspicious tissue and guide a biopsy. The machine takes X-rays of your breast from multiple angles and sends this information to a computer. The radiologist selects the abnormal area to biopsy. Based on this, the computer uses calculations to guide the radiologist to place the biopsy device in the correct area. The radiologist then uses the device to collect the samples from the area.
Throughout the procedure, the radiologist will use this technology to verify that they’re sampling tissue from the correct spot. They’ll ensure they’ve collected enough tissue for a sample that can produce accurate results.
Your healthcare provider will ask questions to ensure the procedure is safe and timed correctly. They’ll ask about:
It’s also a good idea to plan for a close friend or family member to drive you home. Most people are physically able to drive after a stereotactic biopsy. Still, having a procedure to determine if you have cancer can be emotionally draining and stressful. It can help to have someone you trust close by.
Plan for the procedure to take about an hour in total. The biopsy part should only take a few minutes. On the day of your biopsy:
You’ll be awake for the entire procedure, but your breast will be numb, so you won’t feel pain.
Afterward, a healthcare provider will put pressure on the biopsy site to stop any bleeding. They’ll cover it with gauze or a bandage. They may apply an ice pack to prevent swelling.
Finally, you’ll have a gentle mammogram so the radiologist can make sure the biopsy clip is in the correct location.
You may need a brief recovery period before you leave, but you’ll be able to go home that same day. You may notice slight bruising or swelling and experience some soreness, but this usually improves within a few weeks at most.
If you’re uncomfortable, your healthcare provider may recommend over-the-counter pain medicine. You should apply an ice pack to the area (20 minutes on and 20 minutes off) for the first few hours after the biopsy. You’ll receive additional instructions on how to take care of the area.
It’s a good idea to avoid any strenuous activity for 24 to 48 hours after the biopsy. Most people can resume their routine after this waiting period, but some may need more time. Follow your healthcare provider’s guidance about caring for yourself while you recover.
A stereotactic biopsy is a safe procedure. Still, any procedure that requires incisions (cuts) comes with certain risks, including bleeding, fluid or blood build-up and infection.
Most people don’t experience pain during the procedure because of the anesthesia. You may feel a slight pinch or prick when you get the anesthesia injection. You may feel pressure when the biopsy needle goes in.
Some people are more likely to experience pain or discomfort than others. For instance, if you have dense breast tissue or if the tumor is directly behind a sensitive area (like your nipple), you may be more likely to feel pain or discomfort during the biopsy.
Most discomfort relates to remaining in the same position for an hour. For example, turning your head to lie face down on the table may cause neck stiffness afterward.
The radiologist or your primary care provider will tell you whether you’ve tested positive or negative for cancer. You might need follow-up tests if the results were unclear (inconclusive). Follow your provider’s guidance when it comes to the next steps.
It can take anywhere from a few days to up to a week for results to come in. Before you leave the test, ask your provider how much time you should allow to receive your results and how you’ll receive them.
Having a stereotactic biopsy can feel stressful, as it usually follows a procedure that’s already found suspicious tissue. Most biopsies, however — including stereotactic biopsies — come back negative. A recent study found that less than 30% of people who had a stereotactic biopsy tested positive for cancer.
Call if you’re noticing signs that the biopsy site isn’t healing as it should. Your healthcare provider should know if you have:
A note from Cleveland Clinic
Learning that you’ll need a stereotactic biopsy can feel stressful, as it usually means you have “suspicious” tissue that could be cancer. It’s important to remember that this procedure is still about a diagnosis. Most people — including those with “suspicious” results from a screening procedure — don’t test positive for cancer. In that case, a stereotactic biopsy can put your mind at ease. If you have cancer, this procedure can detect it early, when treatment is most effective.
Last reviewed by a Cleveland Clinic medical professional on 10/04/2022.
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