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How accurate is a sterotactic biopsy?
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How accurate is a sterotactic biopsy?

I just had my first mamogram (mammogram) done the other day and they had to redo it.After the second momogram they brought me in to see what they found . Which was 15-20 small specks on my left breast.  They explained that they are probably calium deposits but they had already spoke to my doctor and they recommend sterotactic biopsy be done. My concern is if they do a biopsy on say 5 specks what about the other 15??  I don't want to go through the test and still not have an answer. They of couse said that it's the procedure of choice because it is less invasive.  I want accurate!!! Any in put would be helpful. Thank you
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Dear RJCC, What they are likely referring to as specks on the mammogram are microcalcifications.  The pattern of these microcalcifications gives clues as to whether something is suspicious - needing further evaluation, or not. Clustering of these microcalcifications would be a suspicious finding.  Scattered microcalcifications are less concerning.  A stereotactic biopsy is done locating the area of concern via mammogram or ultrasound.  They aim for the "specks" or microcalcifications when the biopsy is done.  They would aim for the cluster or area where the majority of "specks" are seen, the mammogram helps to identify the area as accurately as possible.  Once the specimen is obtained they might check it under x-ray to see if the microcalcifications are seen in the specimen.
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My wife just went through a similar situation.  She had a cluster of 5 - 7 specs that appeared to be calcium. A stereotactic biopsy was performed and the pathology report came back saying that she had Ductal Carcinoma in Situ (DCIS) which is a non-invasive form of cancer.  A lumpectomy was scheduled and perfomed a few weeks later.  The pathology report from the "lump" showed that she actually has an invasive form of ductal cancer.  The biopsy core taken had just missed the invasive part of the tumor.  I don't know if it's a question of accuracy with the doctor or the procedure, but it still appears to be a good way to approach it.  If you want your doctor to biopsy all of the specs - ask him/her why not?  From what I understand, the clusters are the areas that should definitely be tested.  Our doctor did not think that we needed a sentinel node biopsy, but offered it as an option - we insisted and it turns out it had indeed spread to her sentinel node.  The main thing you have to do now - which it appears you are doing - is ask questions and take charge of your care.  Get books - Dr. Susan Love's Breast Book is great.  And remain positive!
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If you saw 15 red things that looked alike, and looked like apples floating in a bucket, and picked up 5 and they were all apples, it'd be pretty safe to say the rest were, too. Likewise, if the stereotactic biopsy shows some of the calcifications, it's a highly reliable way to assess them all. In the case mentioned by the other commenter, the biopsy didn't really "miss" anything. What was done was exactly what always would be done when such a biopsy found DCIS; namely, to remove the whole area. The bottom line is that stereotactic biopsy is very accurate; especially when there's such a specific target, meaning calcifications. It's easy to know whether they are in the sample. If the biopsy were not to have calcifications within the specimen, then you'd have to wonder if the area were missed.
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Thank you for all of your in put.  I guess I am just really worried that the biopsy will tell me it's clear and it's really not.  10 yrs ago I lost my 46yr old sister to Kidney cancer do to false reading.  She kept going in and insisting for further testing for 1yr prior to her dignosis until a lump showed up on her neck & it was in the lymp nodes and all over. Should I start to plan now for a full biopsy just to be sure?
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Avatar_n_tn
If it's going to drive you crazy worrying, the alternative is a wire-localized biopsy, wherein the radiologist places a wire into the area of concern, and the surgeon follows the wire and removes the entire area. It's still an outpatient procedure, and by removing the entire area should give you the peace of mind you seek
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