Discovering an abnormal breast lump used to mean a surgical biopsy to determine if the lump was cancerous.

But with a stereotactic breast biopsy, doctors can obtain breast tissue through a minimally invasive procedure that does not require surgery.

Dr. Paul Smart, an interventional radiologist at Sharon Regional Health System, does about two stereotactic breast biopsies a day. The procedure has been available at Sharon Regional since 1993.

"It essentially replaced the lumpectomy as a diagnosis," Smart said. "We still do a lumpectomy once a patient is known to have breast cancer."

If a woman has an abnormal mammogram, the radiologist usually reports the abnormality to the patient’s primary care physician, who then refers the patient to a surgeon for a biopsy. But if a patient has a stereotactic breast biopsy, she can bypass surgery, Smart said.

"It diminishes the time it takes for the patient to be diagnosed and treated," Smart said. "Early diagnosis and treatment is an asset to the patient. We want to get the patient treated as quickly as possible."

Smart said sometimes a patient has to wait up to three weeks to see a surgeon for a biopsy, but radiologists can see a patient for a stereotactic breast biopsy much sooner.

Smart said every year 20 million women have mammograms, and half a million are called back for biopsies. Only 20 percent of the biopsies come back malignant, which means 80 percent of women go through unnecessary surgery.

"We’re able to do a less invasive procedure in 80 percent of the half-million women (who have abnormal mammograms," Smart said. "It saves time; time from work, time from family. The 80 percent who are benign do not have to go on to surgical biopsy. That’s why it’s such an asset."

Anesthesia presents a risk with surgery, and the incision leaves a scar, which can mimic lesions on future mammograms, Smart said.

A stereotactic breast biopsy is performed under local anesthesia and intramuscular sedation, he said.

Radiologists use computer images to determine where to insert the probe that collects the breast tissue. After it is inserted, the probe rotates and then extracts the tissue, which looks like strings of spaghetti. After the biopsy, a small metal clip is placed at the site as a guide for the surgeon, if the patient needs a lumpectomy.

Sharon Regional uses an upright system for the procedure, which means the patient sits in a chair in front of the probe. The chair can also be adjusted so the patient can lay on her side, Smart said. In other systems, the patient lays on her stomach with her breast through an aperture, he said.

A surgical biopsy takes all day, but a stereotactic breast biopsy takes about one to two hours, Smart said.

"You’d never get that turn-around in the O.R.," he said.

After the procedure, the breast is compressed to prevent bleeding and the patient is sent home. Patients should avoid strenuous activity after the procedure and should not drive for 24 hours if they have been sedated, Smart said.

The test results are available for the referring physician by the next evening, Smart said. If the test comes back positive, the patient has to have a lumpectomy, Smart said.

Smart said he is happy to offer the less invasive procedure to patients who need breast biopsies.

"It makes me feel good that we can do biopsies, and you don’t feel you’re taking your patients through an invasive or risky procedure," Smart said.