Wire Guided vs. Sterotactic Biopsy

[Kelley1968]

I recently had my first mammogram and according to the radiology report I have 7-8 microcalcifications in the upper right quadrant of my right breast.  The radiologist has recommended a wire guided or excisional biopsy. Why is sterotactic not an option? Also,  it says bi-rad 4, suspicious for malignancy(low).  Is it because of where it's located? I don't see a surgeon until next Tuesday and would like to be prepared with questions. Thanks!

[DrBhumikaMD]

Hi,
You need to discuss this in detail with your radiologist and surgeon. If the microcalcifications are in a limited area you could even discus the option of a surgical excision biopsy so that the calcifications are removed and adequate tissue sample is got for a confirmed diagnosis. If however the microcalcifications are scattered then you will have to go ahead with the wire guided biopsy. A wire guided biopsy is done when the calcium specks are scattered and then localised using a wire and then a biopsy taken. You could discuss whether a stereotactic biopsy would be successful in taking a biopsy of the lesion, and your radiologist or surgeon will tell you if that is an option. Goodluck.

[Kelley1968]

The surgeon (who is at a different facility from the radiologist), pretty much scoffed at the idea of a wire guided or excisional biopsy - said they don't do those there (it's a breast cancer center). He said with the stereotactic biopsy there is a 50% chance that they wouldn't be able to see the microcalcifications. Basically said I could wait six months and have another mammogram or have the stereotactic biopsy which may not be successful. He gave me options but seemed to lean toward waiting and watching. I don't feel comfortable because I'm getting two different opinions. I guess I'll be going to another surgeon for another opinion.

[DrBhumikaMD]

Hi,
The difference in opinion between two specialists does put you in a fix at times. But that happens rarely. I suggest you should go ahead and follow on the surgeon's advice because of his having a clinical as well as radiological perspective of your case. He would know whats the best suited option for you right now. If he suggests a wait and watch policy, you can follow up after 6 months and get a repeat mammogram done. But if you still not convinced you can get a second opinion. Goodluck.