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Breast
Procedures
Image-Guided Procedures
Stereotactic Biopsy, Prone
Stereotactic Biopsy, Prone
Ethan O. Cohen, MD; Wendie A. Berg, MD, PhD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          TERMINOLOGY

          • Synonyms

            • Stereotaxic biopsy

          • Definitions

            • Mammographically-guided biopsy using 2 stereotactic images (taken at +15° and -15° angles) or 1 tomosynthesis series for targeting with patient positioned prone on stereotactic table

          PREPROCEDURE

          • Indications

            • Contraindications

              • Getting Started

                PROCEDURE

                • Patient Position/Location

                  • Procedure Steps

                    • Findings and Reporting

                      • Alternative Procedures/Therapies

                        POST PROCEDURE

                        • Expected Outcome

                          • Things to Do

                            • Things to Avoid

                              OUTCOMES

                              • Complications

                                Selected References

                                1. Bahl M et al: Comparison of upright digital breast tomosynthesis-guided versus prone stereotactic vacuum-assisted breast biopsy. Radiology. 290(2):298-304, 2018
                                2. Calhoun BC: Core needle biopsy of the breast: an evaluation of contemporary data. Surg Pathol Clin. 11(1):1-16, 2018
                                3. Falkner NM et al: Added value of second biopsy target in screen-detected widespread suspicious breast calcifications. J Med Imaging Radiat Oncol. 62(3):299-306, 2018
                                4. Gao Y et al: What happens after a diagnosis of high-risk breast lesion at stereotactic vacuum-assisted biopsy? An observational study of postdiagnosis management and imaging ddherence. Radiology. 171665, 2018
                                5. Shin K et al: Tomosynthesis-guided core biopsy of the breast: why and how to use it. J Clin Imaging Sci. 8:28, 2018
                                6. Chesebro AL et al: Troubleshooting to overcome technical challenges in image-guided breast biopsy. Radiographics. 37(3):705-18, 2017
                                7. Jain A et al: Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration. Eur Radiol. 27(11):4797-4803, 2017
                                8. Plecha DM et al: Comparing cancer detection rates of patients undergoing short term follow-up vs routine follow-up after benign breast biopsies, is follow-up needed? Clin Imaging. 42:37-42, 2017
                                9. Ruggirello I et al: Stereotactic vacuum-assisted breast biopsy: Comparison between 11- and 8-gauge needles. Eur J Surg Oncol. 43(12):2257-2260, 2017
                                10. Monticciolo DL et al: Six-Month Short-Interval Imaging Follow-Up for Benign Concordant Core Needle Biopsy of the Breast: Outcomes in 1444 Cases With Long-Term Follow-Up. AJR Am J Roentgenol. 1-6, 2016
                                11. Mooney KL et al: Upgrade rates of high-risk breast lesions diagnosed on core needle biopsy: a single-institution experience and literature review. Mod Pathol. 29(12):1471-1484, 2016
                                12. Raj SD et al: Stereotactic biopsy of segmental breast calcifications: Is sampling of anterior and posterior components necessary? Acad Radiol. 23(6):682-6, 2016
                                13. Johnson JM et al: Breast cancer detection with short-interval follow-up compared with return to annual screening in patients with benign stereotactic or US-guided breast biopsy results. Radiology. 275(1):54-60, 2015
                                14. Mateo AM et al: Is 6-Month Radiologic Imaging Necessary after Benign Breast Biopsy? Review of Literature and Multicenter Experience. Am Surg. 81(12):1224-7, 2015
                                15. Schrading S et al: Digital breast tomosynthesis-guided vacuum-assisted breast biopsy: initial experiences and comparison with prone stereotactic vacuum-assisted biopsy. Radiology. 274(3):654-62, 2015
                                16. Becker AK et al: Flat ductal intraepithelial neoplasia 1A diagnosed at stereotactic core needle biopsy: is excisional biopsy indicated? AJR Am J Roentgenol. 200(3):682-8, 2013
                                17. Chaudhary S et al: Classic lobular neoplasia on core biopsy: a clinical and radio-pathologic correlation study with follow-up excision biopsy. Mod Pathol. 26(6):762-71, 2013
                                18. Gümüş H et al: Breast microcalcification: diagnostic value of calcified and non-calcified cores on specimen radiographs. Breast J. 19(2):156-61, 2013
                                19. Gümüş H et al: Causes of failure in removing calcium in microcalcification-only lesions using 11-gauge stereotactic vacuum-assisted breast biopsy. Diagn Interv Radiol. 18(4):354-9, 2012
                                20. Lee KA et al: Risk of malignancy when microscopic radial scars and microscopic papillomas are found at percutaneous biopsy. AJR Am J Roentgenol. 198(2):W141-5, 2012
                                21. Venkataraman S et al: Stereotactic core biopsy: Comparison of 11 gauge with 8 gauge vacuum assisted breast biopsy. Eur J Radiol. 81(10):2613-9, 2012
                                22. Londero V et al: Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device. Eur Radiol. 21(6):1200-6, 2011
                                23. Bruening W et al: Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med. 152(4):238-46, 2010
                                24. Kohr JR et al: Risk of upgrade of atypical ductal hyperplasia after stereotactic breast biopsy: effects of number of foci and complete removal of calcifications. Radiology. 255(3):723-30, 2010
                                25. Penco S et al: Stereotactic vacuum-assisted breast biopsy is not a therapeutic procedure even when all mammographically found calcifications are removed: analysis of 4,086 procedures. AJR Am J Roentgenol. 195(5):1255-60, 2010
                                26. Jackman RJ et al: False-negative diagnoses at stereotactic vacuum-assisted needle breast biopsy: long-term follow-up of 1,280 lesions and review of the literature. AJR Am J Roentgenol. 192(2):341-51, 2009
                                27. Somerville P et al: Anticoagulation and bleeding risk after core needle biopsy. AJR Am J Roentgenol. 191(4):1194-7, 2008
                                28. Ciatto S et al: Accuracy and underestimation of malignancy of breast core needle biopsy: the Florence experience of over 4000 consecutive biopsies. Breast Cancer Res Treat. 101(3):291-7, 2007
                                29. Lourenco AP et al: Stereotactic breast biopsy: comparison of histologic underestimation rates with 11- and 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 189(5):W275-9, 2007
                                30. Mahoney MC et al: Lobular neoplasia at 11-gauge vacuum-assisted stereotactic biopsy: correlation with surgical excisional biopsy and mammographic follow-up. AJR Am J Roentgenol. 187(4):949-54, 2006
                                31. Berg WA: Image-guided breast biopsy and management of high-risk lesions. Radiol Clin North Am. 42(5):935-46, vii, 2004
                                32. Esserman LE et al: Recognizing pitfalls in early and late migration of clip markers after imaging-guided directional vacuum-assisted biopsy. Radiographics. 24(1):147-56, 2004
                                33. Fajardo LL et al: Stereotactic and sonographic large-core biopsy of nonpalpable breast lesions: results of the Radiologic Diagnostic Oncology Group V study. Acad Radiol. 11(3):293-308, 2004
                                34. Jackman RJ et al: Stereotactic histologic biopsy with patients prone: technical feasibility in 98% of mammographically detected lesions. AJR Am J Roentgenol. 180(3):785-94, 2003
                                35. Jacobs TW et al: Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 26(9):1095-110, 2002
                                36. Kass R et al: Clip migration in stereotactic biopsy. Am J Surg. 184(4):325-31, 2002
                                37. Liberman L et al: To excise or to sample the mammographic target: what is the goal of stereotactic 11-gauge vacuum-assisted breast biopsy? AJR Am J Roentgenol. 179(3):679-83, 2002
                                38. Liberman L: Percutaneous image-guided core breast biopsy. Radiol Clin North Am. 40(3):483-500, vi, 2002
                                39. Brenner RJ et al: Stereotactic core-needle breast biopsy: a multi-institutional prospective trial. Radiology. 218(3):866-72, 2001
                                40. Carr JJ et al: Stereotactic localization of breast lesions: how it works and methods to improve accuracy. Radiographics. 21(2):463-73, 2001
                                41. Jackman RJ et al: Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology. 218(2):497-502, 2001
                                42. Darling ML et al: Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. AJR Am J Roentgenol. 175(5):1341-6, 2000
                                43. Lamm RL et al: Mammographic abnormalities caused by percutaneous stereotactic biopsy of histologically benign lesions evident on follow-up mammograms. AJR Am J Roentgenol. 174(3):753-6, 2000
                                44. Liberman L: Clinical management issues in percutaneous core breast biopsy. Radiol Clin North Am. 38(4):791-807, 2000
                                45. Melotti MK et al: Core needle breast biopsy in patients undergoing anticoagulation therapy: preliminary results. AJR Am J Roentgenol. 174(1):245-9, 2000
                                46. Jackman RJ et al: Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology. 204(2):485-8, 1997
                                47. Liberman L et al: Stereotaxic 14-gauge breast biopsy: how many core biopsy specimens are needed? Radiology. 192(3):793-5, 1994
                                48. Parker SH et al: Percutaneous large-core breast biopsy: a multi-institutional study. Radiology. 193(2):359-64, 1994
                                Related Anatomy
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Preprocedure

                                    • Procedure

                                      • Post Procedure

                                        TERMINOLOGY

                                        • Synonyms

                                          • Stereotaxic biopsy

                                        • Definitions

                                          • Mammographically-guided biopsy using 2 stereotactic images (taken at +15° and -15° angles) or 1 tomosynthesis series for targeting with patient positioned prone on stereotactic table

                                        PREPROCEDURE

                                        • Indications

                                          • Contraindications

                                            • Getting Started

                                              PROCEDURE

                                              • Patient Position/Location

                                                • Procedure Steps

                                                  • Findings and Reporting

                                                    • Alternative Procedures/Therapies

                                                      POST PROCEDURE

                                                      • Expected Outcome

                                                        • Things to Do

                                                          • Things to Avoid

                                                            OUTCOMES

                                                            • Complications

                                                              Selected References

                                                              1. Bahl M et al: Comparison of upright digital breast tomosynthesis-guided versus prone stereotactic vacuum-assisted breast biopsy. Radiology. 290(2):298-304, 2018
                                                              2. Calhoun BC: Core needle biopsy of the breast: an evaluation of contemporary data. Surg Pathol Clin. 11(1):1-16, 2018
                                                              3. Falkner NM et al: Added value of second biopsy target in screen-detected widespread suspicious breast calcifications. J Med Imaging Radiat Oncol. 62(3):299-306, 2018
                                                              4. Gao Y et al: What happens after a diagnosis of high-risk breast lesion at stereotactic vacuum-assisted biopsy? An observational study of postdiagnosis management and imaging ddherence. Radiology. 171665, 2018
                                                              5. Shin K et al: Tomosynthesis-guided core biopsy of the breast: why and how to use it. J Clin Imaging Sci. 8:28, 2018
                                                              6. Chesebro AL et al: Troubleshooting to overcome technical challenges in image-guided breast biopsy. Radiographics. 37(3):705-18, 2017
                                                              7. Jain A et al: Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration. Eur Radiol. 27(11):4797-4803, 2017
                                                              8. Plecha DM et al: Comparing cancer detection rates of patients undergoing short term follow-up vs routine follow-up after benign breast biopsies, is follow-up needed? Clin Imaging. 42:37-42, 2017
                                                              9. Ruggirello I et al: Stereotactic vacuum-assisted breast biopsy: Comparison between 11- and 8-gauge needles. Eur J Surg Oncol. 43(12):2257-2260, 2017
                                                              10. Monticciolo DL et al: Six-Month Short-Interval Imaging Follow-Up for Benign Concordant Core Needle Biopsy of the Breast: Outcomes in 1444 Cases With Long-Term Follow-Up. AJR Am J Roentgenol. 1-6, 2016
                                                              11. Mooney KL et al: Upgrade rates of high-risk breast lesions diagnosed on core needle biopsy: a single-institution experience and literature review. Mod Pathol. 29(12):1471-1484, 2016
                                                              12. Raj SD et al: Stereotactic biopsy of segmental breast calcifications: Is sampling of anterior and posterior components necessary? Acad Radiol. 23(6):682-6, 2016
                                                              13. Johnson JM et al: Breast cancer detection with short-interval follow-up compared with return to annual screening in patients with benign stereotactic or US-guided breast biopsy results. Radiology. 275(1):54-60, 2015
                                                              14. Mateo AM et al: Is 6-Month Radiologic Imaging Necessary after Benign Breast Biopsy? Review of Literature and Multicenter Experience. Am Surg. 81(12):1224-7, 2015
                                                              15. Schrading S et al: Digital breast tomosynthesis-guided vacuum-assisted breast biopsy: initial experiences and comparison with prone stereotactic vacuum-assisted biopsy. Radiology. 274(3):654-62, 2015
                                                              16. Becker AK et al: Flat ductal intraepithelial neoplasia 1A diagnosed at stereotactic core needle biopsy: is excisional biopsy indicated? AJR Am J Roentgenol. 200(3):682-8, 2013
                                                              17. Chaudhary S et al: Classic lobular neoplasia on core biopsy: a clinical and radio-pathologic correlation study with follow-up excision biopsy. Mod Pathol. 26(6):762-71, 2013
                                                              18. Gümüş H et al: Breast microcalcification: diagnostic value of calcified and non-calcified cores on specimen radiographs. Breast J. 19(2):156-61, 2013
                                                              19. Gümüş H et al: Causes of failure in removing calcium in microcalcification-only lesions using 11-gauge stereotactic vacuum-assisted breast biopsy. Diagn Interv Radiol. 18(4):354-9, 2012
                                                              20. Lee KA et al: Risk of malignancy when microscopic radial scars and microscopic papillomas are found at percutaneous biopsy. AJR Am J Roentgenol. 198(2):W141-5, 2012
                                                              21. Venkataraman S et al: Stereotactic core biopsy: Comparison of 11 gauge with 8 gauge vacuum assisted breast biopsy. Eur J Radiol. 81(10):2613-9, 2012
                                                              22. Londero V et al: Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device. Eur Radiol. 21(6):1200-6, 2011
                                                              23. Bruening W et al: Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med. 152(4):238-46, 2010
                                                              24. Kohr JR et al: Risk of upgrade of atypical ductal hyperplasia after stereotactic breast biopsy: effects of number of foci and complete removal of calcifications. Radiology. 255(3):723-30, 2010
                                                              25. Penco S et al: Stereotactic vacuum-assisted breast biopsy is not a therapeutic procedure even when all mammographically found calcifications are removed: analysis of 4,086 procedures. AJR Am J Roentgenol. 195(5):1255-60, 2010
                                                              26. Jackman RJ et al: False-negative diagnoses at stereotactic vacuum-assisted needle breast biopsy: long-term follow-up of 1,280 lesions and review of the literature. AJR Am J Roentgenol. 192(2):341-51, 2009
                                                              27. Somerville P et al: Anticoagulation and bleeding risk after core needle biopsy. AJR Am J Roentgenol. 191(4):1194-7, 2008
                                                              28. Ciatto S et al: Accuracy and underestimation of malignancy of breast core needle biopsy: the Florence experience of over 4000 consecutive biopsies. Breast Cancer Res Treat. 101(3):291-7, 2007
                                                              29. Lourenco AP et al: Stereotactic breast biopsy: comparison of histologic underestimation rates with 11- and 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 189(5):W275-9, 2007
                                                              30. Mahoney MC et al: Lobular neoplasia at 11-gauge vacuum-assisted stereotactic biopsy: correlation with surgical excisional biopsy and mammographic follow-up. AJR Am J Roentgenol. 187(4):949-54, 2006
                                                              31. Berg WA: Image-guided breast biopsy and management of high-risk lesions. Radiol Clin North Am. 42(5):935-46, vii, 2004
                                                              32. Esserman LE et al: Recognizing pitfalls in early and late migration of clip markers after imaging-guided directional vacuum-assisted biopsy. Radiographics. 24(1):147-56, 2004
                                                              33. Fajardo LL et al: Stereotactic and sonographic large-core biopsy of nonpalpable breast lesions: results of the Radiologic Diagnostic Oncology Group V study. Acad Radiol. 11(3):293-308, 2004
                                                              34. Jackman RJ et al: Stereotactic histologic biopsy with patients prone: technical feasibility in 98% of mammographically detected lesions. AJR Am J Roentgenol. 180(3):785-94, 2003
                                                              35. Jacobs TW et al: Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 26(9):1095-110, 2002
                                                              36. Kass R et al: Clip migration in stereotactic biopsy. Am J Surg. 184(4):325-31, 2002
                                                              37. Liberman L et al: To excise or to sample the mammographic target: what is the goal of stereotactic 11-gauge vacuum-assisted breast biopsy? AJR Am J Roentgenol. 179(3):679-83, 2002
                                                              38. Liberman L: Percutaneous image-guided core breast biopsy. Radiol Clin North Am. 40(3):483-500, vi, 2002
                                                              39. Brenner RJ et al: Stereotactic core-needle breast biopsy: a multi-institutional prospective trial. Radiology. 218(3):866-72, 2001
                                                              40. Carr JJ et al: Stereotactic localization of breast lesions: how it works and methods to improve accuracy. Radiographics. 21(2):463-73, 2001
                                                              41. Jackman RJ et al: Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology. 218(2):497-502, 2001
                                                              42. Darling ML et al: Atypical ductal hyperplasia and ductal carcinoma in situ as revealed by large-core needle breast biopsy: results of surgical excision. AJR Am J Roentgenol. 175(5):1341-6, 2000
                                                              43. Lamm RL et al: Mammographic abnormalities caused by percutaneous stereotactic biopsy of histologically benign lesions evident on follow-up mammograms. AJR Am J Roentgenol. 174(3):753-6, 2000
                                                              44. Liberman L: Clinical management issues in percutaneous core breast biopsy. Radiol Clin North Am. 38(4):791-807, 2000
                                                              45. Melotti MK et al: Core needle breast biopsy in patients undergoing anticoagulation therapy: preliminary results. AJR Am J Roentgenol. 174(1):245-9, 2000
                                                              46. Jackman RJ et al: Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology. 204(2):485-8, 1997
                                                              47. Liberman L et al: Stereotaxic 14-gauge breast biopsy: how many core biopsy specimens are needed? Radiology. 192(3):793-5, 1994
                                                              48. Parker SH et al: Percutaneous large-core breast biopsy: a multi-institutional study. Radiology. 193(2):359-64, 1994
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