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Breast Procedures

Breast Biopsy

Sometimes we do find a lesion that requires a biopsy for diagnosis. Fortunately, the vast majority of breast biopsies can be accurately performed with a needle and do not require surgery. Depending on the finding, a needle biopsy is performed using stereotactic (mammographic), ultrasound or MRI guidance.

  • Stereotactic-Guided Breast Biopsy. The stereotactic table is specially designed so that you can lie comfortably face-down with one breast positioned through a hole in the table. Digital x-ray images are taken from different angles, allowing the radiologist to precisely localize the area to biopsied. Once the area has been located, the radiologist numbs the area with a local anesthetic and then uses computer guidance for precise needle placement and collection of tissue samples. This procedure usually takes no more than 30 minutes.
  • Ultrasound-Guided Breast Biopsy. The radiologist uses ultrasound to locate the area for biopsy and to direct the needle used in collecting breast tissue samples. This biopsy is done comfortably in the ultrasound suite, usually in less than 10 minutes.
  • MRI-Guided Breast Biopsy. If a lesion is detected only on a Breast MRI exam, a needle biopsy can be performed using MRI guidance. This is done in the MRI suite using a technique similar to other breast biopsies and can be performed comfortably in under an hour.

These methods are as accurate as a surgical biopsy, are performed on an outpatient basis and require no stitches. Furthermore, the patient can resume normal, non-strenuous activities immediately after the procedure is done. The samples are sent to the pathology lab for analysis. Results are usually available within 48 hours.

Ductography

A ductogram, also called a galactogram, is a test done if you are having persistent nipple discharge from a single duct and your mammogram is normal. A tiny tube is inserted into the duct and a tiny amount of iodine contrast dye is injected into the duct. Several mammogram pictures are then obtained with the ducts outlined by the contrast agent. This shows whether there is anything inside the duct which could be producing the discharge. Most women report that this is not painful. When the duct is filled with fluid, you may feel a mild cramping sensation similar to what many women experience with their menstrual cycle.