RadteraStereotactic (Mammographic) Breast Biopsy
MammoNo contrastBreast
Indications
- Suspicious calcifications (BI-RADS 4/5) without sonographic correlate
- Architectural distortion or focal asymmetry seen mammographically but occult on US
- Mammography/tomosynthesis-detected lesion requiring tissue diagnosis when not visible on US
Patient prep
- Review anticoagulation/antiplatelet status and hold per facility policy
- No deodorant/powder; confirm target visible on scout/stereo pairs
- Informed consent; position prone (dedicated stereo table) or upright (add-on unit)
Contrast
None / non-contrast
Technique
- Localize target with stereo pair images at +/-15 degrees (or DBT-guided / tomosynthesis localization) to compute depth (z-axis)
- Local anesthetic; vacuum-assisted core needle advanced to target
- Vacuum-assisted biopsy (VAB) acquires multiple contiguous cores; specimen radiograph to confirm calcifications retrieved
- Deploy a tissue/clip marker at the biopsy site; obtain post-procedure CC and ML mammogram to document clip position
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Scout + stereo pairs | 0 and +/-15 degrees | Target localization and depth calculation |
| 2 | Pre-fire / post-fire stereo | +/-15 degrees | Confirm needle position at target |
| 3 | Specimen radiograph | Specimen | Verify retrieval of calcifications |
| 4 | Post-procedure CC + ML | Craniocaudal / lateral | Document marker clip placement |
Key points
- VAB preferred over spring core for calcifications — larger contiguous sample reduces underestimation/repeat biopsy
- Always confirm calcification retrieval on specimen radiograph; submit specimen separately for path correlation
- Marker clip is essential to relocalize if surgery/MRI follow
- Establish radiologic-pathologic concordance; discordant or upgrade-risk lesions (e.g., ADH) warrant surgical excision
References
• ACR Practice Parameter for the Performance of Stereotactic-Guided Breast Interventional Procedures
• ACR BI-RADS Atlas, 5th ed.
• Radiopaedia: Stereotactic breast biopsy ( link
• ACR BI-RADS Atlas, 5th ed.
• Radiopaedia: Stereotactic breast biopsy ( link
Source: Researched — verify against your institution
‹ PreviousScreening Mammography with Tomosynthesis (DBT)Next ›CT Abdomen and Pelvis With Contrast (Routine)
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.