Previously, findings that were seen only on 3D mammograms required women to have a surgical biopsy. Increasingly more women are opting for 3D mammography for their annual breast exam; studies have shown that it improves cancer detection in some women and also reduces the number of false alarms.
“Once we implemented tomosynthesis (3D mammography) in our clinic, we started finding breast lesions that were only detectable with ‘tomo,’ ” says Catherine (Kate) Appleton, MD, chief of the breast imaging section at Mallinckrodt Institute of Radiology. “But we couldn’t use our existing needle biopsy technique to get a diagnosis.”
More specifically, they couldn’t perform a stereotactic breast biopsy. A stereotactic breast biopsy is an outpatient procedure in which a needle is inserted into the breast to remove tissue samples for examination. “Consequently, women with these tiny lesions were sent off to the OR (operating room) with a small guidewire placed by the radiologist to help the surgeon locate and biopsy the suspicious area,” says Appleton.
The new biopsy system addresses that issue and more.
“The Affirm system permits accurate pre-operative diagnosis. It has also proven to be faster in some cases as well,” says Appleton. Because the new system allows patients to be seated during the procedure, rather than be prone (lying face down on a table), some patients such as the very elderly, or those with back problems, can now be accommodated.
Presently MIR radiologists perform 3D tomosynthesis biopsies in one of the mammography diagnostic rooms at the Joanne F. Knight Breast Health Center. The new system snaps onto the mammography unit and the patient is seated in a chair with her breast compressed by the technologist, just as she would with a mammogram.
Patient response to the new biopsy system has been positive even among those who have had the regular stereotactic biopsy in the past,” Appleton says. “This device is a great addition to our practice and allows us to serve even more patients.”