Background Information:

What are the other Names for the Procedure?

• Breast Biopsy using Mammography
• X-ray Guided Biopsy of Breast
• X-ray Guided Needle Biopsy of the Breast

What is Mammographically-Guided Breast Biopsy radiology procedure? (General Explanation)

• A breast biopsy is used to determine, if a suspicious lump of cells in the breast is cancerous or benign
• It may be performed surgically or through a hollow needle. If it is performed using X-rays, it is called a Mammographically-Guided Breast Biopsy
• A stereotactic biopsy is a type of mammography instrument. Stereotactic guidance is used in biopsy to guide the instrument to the suspicious tissues or mass in the breast

What part of the Body does the Procedure involve?

The Breast Biopsy using Mammography involves the chest area of the body.

Why is the Mammographically-Guided Breast Biopsy radiology procedure Performed?

• A Mammographically-Guided Breast Biopsy procedure is used to perform a biopsy on calcium deposits, abnormal tissues, and any other suspicious mass
• It is used to guide biopsy instrument in core needle procedure (where a hollow needle is used to remove the sample) and vacuum-assisted device (when vacuum is used to remove the sample)

What is the Equipment used? (Description of Equipment)

The equipment for the Mammographically-Guided Breast Biopsy procedure consists of the following:

• The mammography unit looks like a rectangular box with a tube, where X-rays are produced
• The unit as a device keeps the breasts in position, to take images more accurately
• A core needle or vacuum-assisted device is used to remove the sample from the suspicious tissue

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Mammographically-Guided Biopsy of Breast procedure.

What is the Cost of Performing the Mammographically-Guided Breast Biopsy radiology procedure?

The cost of the Mammographically-Guided Breast Biopsy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Mammographically-Guided Biopsy of Breast procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=breastbixr (accessed on 08/03/2014)

Prior to Mammographically-Guided Biopsy radiology procedure:

How does the Mammographically-Guided Biopsy radiology procedure work?

A Mammographically-Guided Biopsy of Breast procedure works in the following manner:

• The stereotactic mammography produces images of the breast from different angles
• Using these images, the radiologist determines the position of the suspicious mass and inserts a needle, to remove the sample from that mass

How is the Mammographically-Guided Biopsy radiology procedure Performed?

Mammographically-Guided Biopsy of Breast procedure is performed in the following manner:

• The patient lies face-down on the table
• The target breast(s) is positioned in the opening of the table
• The radiologist determines the position of suspicious mass and placement of the needle with the help of the X-ray images
• The section of the breast, where the needle will be inserted, is numbed through anesthesia
• The needle is inserted and is guided to the target piece, with the help of stereotactic x-ray images
• A sample is taken from the suspicious section and the needle is removed
• A marker may be put to locate the site in future

Where is the Procedure Performed?

A Mammographically-Guided Biopsy of Breast procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A Mammographically-Guided Biopsy of Breast procedure is usually done by a radiology technologist.

How long will the Procedure take?

The Mammographically-Guided Breast Biopsy procedure takes about an hour.

Who interprets the Result?

• The tissue removed from the Breast Biopsy using Mammography procedure is sent to the pathologist
• The pathologist will examine the tissue under a microscope and give the results to the interventional radiologist

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• The patient may be asked to stop taking certain medications, such as aspirin or other blood thinner medicines, before biopsies
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, or to the anesthesia, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• Patients are advised not to wear powder, perfume, or lotion, during the examination
• It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
• The patient may be asked to avoid eating or drinking, several hours before the test
• The patients may be required to be driven home, after the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for a Mammographically-Guided Breast Biopsy procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Mammographically-Guided Breast Biopsy procedure:

• There is little to no recovery time needed after the procedure
• The procedure is relatively inexpensive compared to a surgical biopsy
• X-rays used in the procedure do not have any side effects; the radiation does not remain in the patient’s body after the examination
• The procedure is not invasive, when compared to a surgical biopsy
• Mammograms taken even after the procedure are not difficult to read, as this procedure does not distort breast tissues
• Mammographically-Guided Breast Biopsy is a very accurate procedure to examine calcium deposits and tiny masses
• It is very fast compared to surgical biopsies
• The procedure is not very painful

Following are the risks of the Mammographically-Guided Breast Biopsy procedure:

• There is a very slight chance of cancer, due to the radiation used in the procedure
• There is a very rare chance of infection after the procedure, as it involves penetration of the skin
• If the biopsy is done to remove the deep tissues in the breast, there is a rare chance that the needle will pass through the chest wall and collapse the lung
• As the vacuum-assisted device removes a large tissue sample, there is a rare chance of bleeding that can cause a hematoma

What are the Limitations of the Mammographically-Guided Breast Biopsy radiology procedure?

Following are the limitations of the Mammographically-Guided Breast Biopsy procedure:

• The procedure may not show the seriousness of the disease, it may also miss the lesion; in such cases, surgical biopsies may be needed
• Suspicious tissues located near the chest wall are difficult to examine using this procedure
• If calcium deposits are scattered around the breast, it may be difficult to perform a stereotactic breast biopsy

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is the Mammographically-Guided Breast Biopsy procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the biopsy procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Mammographically-Guided Breast Biopsy radiology procedure:

What is to be expected during the Mammographically-Guided Breast Biopsy radiology procedure?

The following may be expected during a Mammographically-Guided Biopsy of Breast procedure:

• The patient may feel some pain due to the needle insertion in the skin
• During biopsy requiring surgery, the patient is given anesthesia
• The patient may feel a little discomfort as he/she has to lie face down, for an extended period of time

What kind of Anesthesia is given, during the Procedure?

During the Mammographically-Guided Biopsy of Breast, general anesthesia is injected to numb the path of the needle.

How much Blood will you lose, during the Procedure?

There is only a minimal blood loss involved during the Mammographically-Guided Breast Biopsy procedure. 

What are the possible Risks and Complications during the Mammographically-Guided Breast Biopsy radiology procedure?

• Any procedure, where the skin is penetrated carries a risk of infection. The probability of infection requiring antibiotic treatment is less than 1 in 1,000 procedures
• If a biopsy is performed to remove deep tissues in the breast, there is a rare chance that the needle will pass through the chest wall and collapse the lung
• As the vacuum-assisted device removes a large tissue sample, there is a rare chance of bleeding and causing hematoma

What Post-Operative Care is needed at the Healthcare Facility after the Mammographically-Guided Breast Biopsy radiology procedure?

There is no postoperative care necessary after the Mammographically-Guided Breast Biopsy procedure, at the healthcare facility.

After the Mammographically-Guided Breast Biopsy radiology procedure:

What is to be expected after the Mammographically-Guided Breast Biopsy radiology procedure?

The following may be expected after the Mammographically-Guided Breast Biopsy procedure:

• The doctor may recommend taking over-the-counter pain medication, if there is swelling after the procedure
• However, leaving a marker for biopsy location for future purposes does not cause any additional pain or discomfort

When do you need to call your Physician?

If there are any problems, such as swelling, bleeding, or redness in the breast, following the Mammographically-Guided Biopsy of Breast procedure, the physician should be informed about it.

What Post-Operative Care is needed at Home after the Mammographically-Guided Breast Biopsy radiology procedure?

There is no postoperative care necessary after the Mammographically-Guided Biopsy of Breast procedure.

How long does it normally take to fully recover, from the Procedure?

The patient may return to their normal activities 24 hours after the Mammographically-Guided Biopsy of Breast procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

• The tissue removed is processed in the laboratory under a pathologist's supervision
• Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
• Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Mammographically-Guided Breast Biopsy radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist, performing the procedure
• A pathologist, for analysis of breast biopsy
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Mammographically-Guided Biopsy of Breast procedure is performed.