Return to Main Menu

by Lisa F. Baron, M.D. and Thomas Lee Pope, M.D. Co-Directors, Hollings Mammography Center

As the leading cancer in women and the second cause of cancer-related deaths, breast cancer is an insidious disease that affects a global age range and socioeconomic status.

The risk factors for breast cancer include genetic predisposition, advancing age, early menses and late menopause, history of ionizing radiation to the chest wall and prior biopsy of a high risk lesion (e.g. atypical hyperplasia, Lobular Carcinoma In-Situ).

Nearly 70 percent of all women diagnosed with breast cancer have no obvious risk factor, however, other than being female.

Breast cancer cannot be prevented, but early detection through screening has shown to reduce its mortality and morbidity. Breast cancer screening encompasses a three-prong approach utilizing monthly self-breast examination (SBE), routine clinical breast examination (CBE) and yearly mammograms beginning at age 40. When an abnormality is detected then further evaluation with a biopsy is often recommended.

There are several methods of obtaining a breast biopsy. It is important to understand that there is no “perfect” biopsy which can be used for all patients and that often there are several different methods available. It is also important that the patient understands how and why the biopsy is being performed and to ask questions.

The most common type of breast biopsy is a core needle biopsy or fine needle aspiration. This is when a small sample of tissue is removed from the breast and examined under the microscope by the pathologist.

This is frequently performed under imaging guidance often using an ultrasound machine or a special computer known as a “stereotactic biopsy.” The Hollings Mammography Center is fully accredited in Stereotactic Breast Biopsies (STX) and has had an active program since 1994. The ultrasound and STX guided breast biopsies are performed in the mammography suite in Rutledge Towers. The procedure generally takes between 30-60 minutes and is performed with local anesthesia and without stitches. Typically the patient is able to resume her routine activities following the biopsy with little discomfort.

Some patients have recently inquired about another type of biopsy described as the Advanced Breast Biopsy Instrumentation (ABBI) System. This procedure is not offered at the MUSC as it is a more invasive procedure with a higher complication rate than core biopsy.

In a recent report published in the American Journal of Radiology in May from Columbia University in New York, the authors concluded that “....the ABBI procedure is a more invasive and less readily available procedure than core needle biopsy of sampling of benign breast lesions...and offered no advantages over core needle biopsy....” They also conclude that “...because of its larger cannula size, more deformity of the breast can be expected....”

At times, a surgical biopsy may be initially recommended rather than a core biopsy or FNA. This procedure is performed by the surgeon in the operating room. This is an outpatient procedure and usually performed under local anesthesia along with sedation. Frequently, the patient is able to resume her normal activities within one to two days following the biopsy.

It is important to understand why a biopsy has been recommended and to discuss the options with your health care provider.

If you would like further information about breast biopsies or would like to schedule a mammogram, please call the Hollings Mammography Center at 876-0204.