Breast tissue bulge and lesion visibility during stereotactic biopsy - A phantom study

Background: During mammography guided stereotactic breast biopsy a bulge of tissue can form in the paddle needle biopsy aperture. This bulge has been estimated to have a height of up to 30% of the breast itself. During clinical biopsy we have noticed that lesions can appear to be less visible when tissue bulges are evident. This can make biopsy more difficult in some cases. Objectives: This experiment investigates how lesion visibility varies with breast bulge magnitude. Method: Using a phantom to represent breast and breast bulge, lesion visibility was assessed using a two alternative forced choice methodology. To mimic clinical conditions, imaging was performed on a full field digital mammography system with the biopsy paddle attached using an automatic exposure device. Organ dose (breast) was estimated. Results: As breast bulge increases lesion visibility decreases; organ dose increases as breast bulge magnitude increases. Conclusion: Consideration should be given to the impact of breast bulge magnitude and lesion visibility when performing image guided biopsy. Advances in knowledge: The authors found no similar studies and the results of this study demonstrate a potential clinical risk. (C) 2014 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.