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Stereotactic core biopsy

A stereotactic core biopsy is type of biopsy that uses 3-dimensional images (stereotactic) to find the exact location of a tumour or suspicious area in the breast. These images are used to guide a large hollow needle or probe to obtain a sample of the tissue. This test may also be called stereotactic needle biopsy or x-ray guided needle biopsy.

Why stereotactic core biopsy is done

Stereotactic core biopsy is used:

  • to take a biopsy sample from lumps that cannot be felt (non-palpable) but are seen on mammography
  • when mammography shows a suspicious area of small calcium deposits
  • to take a biopsy sample from a new lump or area of calcification found at a previous site of surgery
  • when the shape of the breast is distorted
  • to determine if a lump is non-cancerous (benign) without having to do a surgical biopsy

How stereotactic core biopsy is done

A stereotactic core biopsy does not usually need any special preparation and does not take very long.

  • The woman lies face down on a special table with her breast hanging through an opening in the table. Sometimes the procedure can be done in a sitting position.
  • The breast is compressed and held in place between 2 plates on the mammography machine.
  • The radiologist views the images and finds the site to be sampled.
  • A local anesthetic is used to numb the area.
  • A small cut (incision) is made in the skin.
  • With the help of computer imaging, the hollow needle or probe is guided into the site to be sampled. The needle has a special cutting device.
  • Several small samples of tissue are removed.
  • The needle must be removed after each sample is taken, and reinserted for the next sample.
  • Two devices can be used to remove more or larger samples of tissue.
    • A special vacuum-assisted device (VAD) biopsy system uses suction to draw tissue into a cylinder inserted into the breast. Mammotome and Minimally Invasive Breast Biopsy (MIBB) are examples of VAD biopsy systems. A rotating knife then cuts the tissue samples from the breast without having to remove and reinsert the device. About twice as much tissue can be removed with this method compared to a core biopsy.
    • The Advanced Breast Biopsy Instrument (ABBI) uses a rotating cylindrical knife to remove a large core of tissue. Stitches may be needed after the procedure because a larger sample is taken.
  • A small metal clip may be left in the area of the biopsy so the area can be located at a later date, if more surgery is needed.
  • After the biopsy is done:
    • Ice and pressure may be applied to the area.
    • A small bandage is used to cover the biopsy site.
    • The person may resume normal activities after 24 hours.

Potential side effects

Side effects can occur with stereotactic core biopsy, but not everyone has them or experiences them in the same way. Most side effects of stereotactic core biopsy are short term and may include:

  • slight bleeding or bruising
  • breast tenderness
  • pain
    • Some women experience pain during the procedure.
  • infection

What the results mean

Biopsy samples are sent to the pathology lab. A pathologist will look at the cells in the tissue to see if they contain cancer. The pathology report indicates the characteristics and type of cells present and if cells are normal, non-cancerous or cancerous.

What happens if a change or abnormality is found

Results from a stereotactic core biopsy usually provide enough information for the doctor to decide whether or not surgery is needed. The doctor will also decide whether further tests or procedures are needed.

Limitations of stereotactic core biopsy

It can be difficult to obtain samples with a stereotactic core biopsy from:

  • lumps just under the skin (superficial lesions)
  • very small areas of calcification (microcalcifications)
  • the inside or outside edge of the breast

In rare situations, a stereotactic core biopsy may miss sampling the area completely, or miss areas that are actually cancerous.

pathology

The study of disease, including causes, development and effects on the body.

The symptoms, processes or conditions of a disease.

A doctor who specializes in the causes and nature of disease is called a pathologist. Pathologists help determine diagnosis, prognosis and treatment by studying cells and tissues under a microscope and using laboratory tests.

Pathological means referring to or having to do with pathology. It can also refer to something related to or caused by a disease, as in pathological fracture.

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