When a breast abnormality is detected, either through a mammogram or through breast examination, it is important to be able to accurately identify and define that abnormality. In some cases this diagnosis can be made directly from mammography, ultrasound, or other study. In other cases of suspected breast cancer (or simply to rule out breast cancer), a bit of tissue must be taken. When breast tissue is taken from the body for examination by a pathologist, the procedure is known as a breast biopsy. A mammotome biopsy is a specific type of breast biopsy. The term mammotome is actually a brand name registered to Ethicon Endo-surgery, Inc. which describes a particular device that can perform vacuum-assisted biopsy.
In contrast to traditional breast biopsy methods which generally required open surgical procedures, vacuum-assisted or mammotome biopsy is performed under local anesthesia. This means that women are able to avoid surgery if the unidentified lesion is determined to be benign. The mammotome device takes a core biopsy which means a reasonably large portion of abnormal breast tissue is removed. This mammotome core biopsy is more diagnostically useful than a simple needle biopsy since it can give pathologists a sample of tissue with much of the anatomy intact. Intact biopsy material is critical to making a determination of stage and grade of cancerous tissue. Thus mammotome breast biopsy eliminates the need for general anesthesia as is required in an open biopsy but provides a better pathological sample than needle biopsy.
There are two main ways that the mammotome biopsy procedure can be improved: by combining the vacuum-assisted mammotome with ultrasound or by using a stereotactic frame. Since the breast abnormality has been detected using imaging or an examination, the precise lesion must be identified before it can be sampled with the mammotome. Often an ultrasound probe is used to precisely locate the breast lump because it does not use radiation and it can be continuous moved to get the best “picture.” In fact, newer versions of the mammotome have an ultrasound probe built right into the device.
Alternatively, stereotactic mammotome biopsy is an approach which uses a rigid framework to hold the breast so that precise measurements can be made of the lesion. Once the breast is locked into the stereotactic apparatus, the mammotome device can be moved into place based on the coordinates determined by mammogram or some other imaging technique.
Even though the mammotome removes a core biopsy, most of the breast remains intact in this approach. Simple tracts are made down to the site of the lesion and portions of the interior of the breast are removed for analysis. In some very successful cases, the entire breast lesion can be removed using a mammotome core biopsy. If the abnormal cells are bordered on all sides by healthy tissue and the abnormal area can no longer be detected on mammogram (or other imaging) the mammotome procedure is not only diagnostic, but therapeutic. This outcome is typical, but can occur.
If you or your doctor has detected a abnormality in your breast, you should discuss your options for diagnosis including a thorough discussion of the vacuum-assisted mammotome biopsy procedure.