Name of the Procedure:

Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance

Summary

This procedure involves taking a small sample of breast tissue using a needle (biopsy), placing a marker or device for precise localization (e.g., clip, metallic pellet), and obtaining images of the removed tissue. This process is guided by magnetic resonance imaging (MRI) to ensure accuracy, especially for additional lesions.

Purpose

This procedure is typically used to:

• Diagnose abnormalities found in the breast
• Determine whether a breast lump or area of concern is benign or malignant
• Facilitate treatment planning by accurately identifying areas of interest

Indications

• Suspicious lumps or abnormalities detected in breast imaging (e.g., mammogram, ultrasound, MRI)
• Palpable breast masses that require further investigation
• Areas of the breast with suspicious changes in size, shape, or density
• Patients with a history of breast cancer undergoing follow-up evaluations

Preparation

• Patients may need to fast for a few hours beforehand.
• Certain medications, particularly blood thinners, may need adjustment.
• A series of diagnostic tests, including prior imaging studies, will be reviewed.

Procedure Description

1. The patient lies on an MRI table, and the breast is positioned and compressed.
2. Local anesthesia is administered to numb the area.
3. Using MRI guidance, the radiologist inserts a needle to obtain a tissue sample.
4. A small marker (e.g., clip, metallic pellet) is placed at the biopsy site for future reference.
5. Additional images are taken to confirm the accurate placement of the marker and to verify the biopsy sample.
6. The needle is removed, and pressure is applied to minimize bleeding.

Duration

Approximately 1 to 2 hours, depending on the number and complexity of lesions.

Setting

This procedure is typically performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist specializing in MRI-guided procedures
• Radiologic technologist
• Nurse or medical assistant
• Possible involvement of an anesthesiologist for sedation

Risks and Complications

• Bruising and swelling at the biopsy site
• Bleeding or hematoma formation
• Infection at the biopsy site
• Pain or discomfort during and after the procedure
• Rarely, damage to nearby structures

Benefits

• Accurate diagnosis of breast tissue abnormalities
• Minimally invasive with a short recovery time
• Guides treatment planning with precise localization
• Provides peace of mind with clear results

Recovery

• Patients might experience mild discomfort or bruising at the site.
• Over-the-counter pain medications can manage minor pain.
• Avoid heavy lifting or strenuous activities for 24-48 hours.
• Follow-up appointments will be scheduled to discuss pathology results and further steps.

Alternatives

• Surgical biopsy: more invasive, longer recovery, but may provide larger tissue samples.
• Observation and regular imaging: could delay diagnosis but avoid invasive procedures.
• Ultrasound-guided or stereotactic biopsy: alternative imaging methods for guidance that may be appropriate depending on the lesion's characteristics.

Patient Experience

• Patients may feel pressure or a brief sting during anesthesia administration.
• Slight pulling or pressure sensations during the tissue sampling.
• Mild discomfort post-procedure, typically manageable with OTC pain relief.
• Any anxiety or concern about the procedure can be alleviated with the support of the medical team.