Stereotactic Breast Biopsy

Stereotactic breast biopsy — also called a stereotactic core needle biopsy — is a minimally invasive outpatient procedure.

During the procedure, a breast radiologist uses mammography imaging technology to guide a needle into a specific area of breast tissue to take a small sample for testing.

UPMC breast imaging experts provide advanced diagnostic care. Our leading-edge mammography technology, combined with our minimally invasive needle biopsy techniques, allows our breast biopsy teams to deliver the fast and accurate results you need.

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What Is Stereotactic Breast Biopsy?

Stereotactic breast biopsy — also called a stereotactic core needle biopsy — is a minimally invasive outpatient procedure.

During the procedure, a breast radiologist uses mammography imaging technology to guide a needle into a specific area of breast tissue to take a small sample for testing.

Benefits of stereotactic breast biopsy

When compared to surgical breast biopsy, stereotactic breast biopsy offers benefits including:

Less invasive.
Reduced scarring.
Shorter procedure time.
Shorter recovery time.

Conditions we diagnose with stereotactic breast biopsy

Atypical ductal hyperplasia.
Atypical lobular hyperplasia.
Breast cancer.
Breast cysts.
Fibroadenomas.
Fibroepithelial lesion.
Flat epithelial atypia.
Intraductal papilloma.
Lobular carcinoma-in-situ.
Microcalcifications.
Mucocele-like lesion.
Radial scar.

Why Might I Need Stereotactic Breast Biopsy?

Your doctor may recommend stereotactic breast biopsy if your mammogram shows an abnormal area of breast tissue. Tissue samples from the abnormal area that are removed during your stereotactic breast biopsy will be tested in a lab for breast cancer and other disorders.

Who’s a candidate for stereotactic breast biopsy?

You may be a candidate for stereotactic breast biopsy if you have a suspicious area of breast tissue that shows up during your mammogram. Breast tissue abnormalities include:

Architectural distortion — An architectural distortion refers to a puckering or overlap of breast tissue that can be caused by cancer, previous surgery, trauma, or a benign condition called a radial scar.
Calcifications — Calcifications are small crystals of calcium phosphate or calcium oxalate that are produced when cells divide or die. Most mammograms show at least a few calcifications, and the vast majority are not cancerous. When there are many calcifications in a small area, and especially if they are new or increasing, your doctor may recommend a biopsy. Calcifications are usually best seen on mammography and, when a biopsy is needed, stereotactic biopsy is usually the recommended option. Only about 20 percent of biopsies for calcifications will show cancer. Another 5-10 percent of biopsies for calcifications will show atypical results.
Masses — If your mammogram shows a mass in your breast, your doctor may order a breast ultrasound or an ultrasound-guided breast biopsy to get a clearer view of the abnormal area. If the mass is not visible during an ultrasound exam, your doctor may recommend a stereotactic breast biopsy.

Alternatives to stereotactic breast biopsy

What Are the Risks and Complications of Stereotactic Breast Biopsy?

Like all medical procedures, stereotactic breast biopsy has some minor risks, including:

Bleeding — There is a small risk (3-6 in 100) of developing a hematoma (a collection of blood under your skin) large enough to cause a lump. This will cause bruising and will eventually go away on its own.
Bruising — A small amount of bruising is normal and varies depending on the amount of bleeding during and after your biopsy. However, you should not have any redness around the biopsy site.
Infection — Infection is very uncommon, affecting less than 1 in 1,000 people after core needle breast biopsy. Symptoms of infection include redness and warmth near the biopsy site. If you have symptoms of infection, contact the biopsy center or your doctor right away.

What Should I Expect From Stereotactic Breast Biopsy?

Before: How to prepare for stereotactic breast biopsy

Your doctor will explain the procedure to you and answer your questions. To prepare for the procedure, you should:

Have your healthcare provider enter an order in the UPMC electronic medical record system or provide you with a written prescription to bring with you to your biopsy.
Stop taking aspirin, aspirin-containing products, and NSAIDs seven days before your biopsy. If you have questions or concerns, please contact the breast center for clarification. You may take acetaminophen one hour before your procedure to minimize discomfort.
Contact your doctor if you are taking blood-thinning medication, such as Coumadin®, warfarin, heparin, Pradaxa®, or Plavix®, to find out if you can safely stop the medication before your biopsy procedure.
Let your doctor or nurse know if your weight exceeds 300 pounds. The stereotactic biopsy table has a weight restriction of 300 pounds. If your weight is between 300 and 350 pounds, stereotactic biopsy can be performed at many of our centers with you seated in a chair.
Let your care team know if you are pregnant or think you might be pregnant.
Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
Let your care team know if you have a nickel allergy.

On the day of your procedure, arrive 30 minutes before your scheduled procedure time. Be sure to bring your photo ID and health insurance card(s).

You should wear a two-piece outfit (shirt and pants/shorts/skirt) and bring a sports bra with you if you have one. Wearing a supportive bra after your procedure can minimize breast movement and discomfort.

You should be able to drive home from the hospital after you are discharged.

How long does stereotactic breast biopsy take?

Stereotactic breast biopsy procedures take about 10 minutes after you are positioned for the procedure. However, you should plan to be at the breast center for up to two hours.

How painful is stereotactic breast biopsy?

Before your biopsy, you will receive an injection of numbing medication that will burn for about 15 seconds. You may feel mild pressure during the biopsy due to breast compression, but you should not feel any pain.

During your stereotactic breast biopsy

There are several stages of the stereotactic breast biopsy procedure, including:

Imaging

You will be asked to lie on your stomach or sit, depending on the equipment being used. Your breast will be compressed just like it is during a standard mammogram, but the pressure may feel more gentle. A small paddle with a central opening is used so your breast radiologist can access the area of concern in your breast. Your breast will stay compressed during the entire procedure, so it is important to remain still. Additional mammogram images are taken during the procedure to make sure samples are being taken from the area of concern.

Local anesthesia

After cleaning your skin, your doctor will inject a numbing medication into the area of your breast to be biopsied. You will feel a burning sensation that will last for about 15 seconds while the medication is given. You may feel some pressure during the procedure, but you should not feel pain.

Tissue sampling

Your breast radiologist will make a small incision in your skin and insert the biopsy needle. After confirming that the needle is in the correct position using your mammogram images, your radiologist will remove several small tissue samples. The tissue samples will be x-rayed to confirm that they have been taken from the area of concern.

Marker placement

A tiny titanium biopsy clip is placed at the biopsy site to mark the area for future breast imaging or surgery. The biopsy clip does not set off metal detectors and is MRI-compatible.

Post-procedure care

Our staff will put pressure on your biopsy incision for about 10 minutes to minimize bleeding. Your biopsy site will be covered with wound closure strips and a bandage. The wound closure strips should be allowed to stay on for about a week, until they fall off on their own. You will also have another mammogram to make sure the biopsy marker is in the correct place.

Recovery after stereotactic breast biopsy

You should be able to drive home after your breast biopsy procedure and resume your normal activities within a few hours. However, you should avoid heavy lifting and keep your biopsy site dry for 24 hours after your procedure. You may notice some tenderness, discomfort, or bruising that should get better within 7-10 days.

During your recovery, you should:

Ask your doctor if it is safe for you to take acetaminophen to manage mild pain or discomfort.
Apply ice to your breast for 15-20 minutes every two hours for the first 24 hours after your biopsy to reduce bruising and swelling. Switch to warm compresses after 48 hours to manage any discomfort.
If you have one, wear a sports bra for the first 24 hours after your biopsy.
Keep your bandage dry and leave it in place for 24 hours after your biopsy. Do not allow your biopsy site to get wet for 24 hours after your biopsy.
Avoid strenuous activity for 24 hours, including pushing, pulling, or lifting more than 10 pounds.
Ask your doctor when it is safe to resume taking blood-thinning medications, if applicable.

When to call your doctor about complications

Call your doctor right away if you notice signs of infection or complications including:

Excessive bleeding.
Redness.
Swelling.

Next steps after your stereotactic breast biopsy

After your stereotactic breast biopsy, our care team will make sure you receive the follow-up care you need.

How will I get my biopsy results?

Our experts understand that waiting for biopsy results can be stressful. It is important to remember that most breast biopsies turn out to be benign (non-cancerous). The nurse will call, or make sure your health care provider has called, to inform you of your biopsy results as soon as your results are received from the pathology department. This usually takes 2-4 business days after your biopsy. Your results will also be sent to your patient portal as soon as they are available.

What percentage of stereotactic biopsies show cancer?

About 20 percent (1 in 5) of all stereotactic breast biopsies show cancer.

What happens if breast cancer is detected?

If your biopsy indicates cancer, you will be referred to UPMC's team of breast cancer experts for treatment. UPMC is nationally recognized and offers the most advanced treatment options available, including surgery, radiation, chemotherapy, and hormonal therapies, along with complementary therapies. Physicians specially trained in the management of breast cancer will review your case with you and develop a personalized treatment plan. Our supportive care team can help you and your loved ones manage the many emotions and questions that may arise throughout the diagnosis, treatment, and recovery process.

What does an 'atypical' result mean?

Your pathologist may report a variety of atypical findings on a core needle biopsy. If you receive an atypical biopsy result, your doctor may recommend that you schedule an appointment at our high-risk breast cancer clinic to discuss risk-reducing strategies.

Atypical ductal hyperplasia (ADH)

Atypical ductal hyperplasia (ADH) is a pre-cancerous condition that occurs when some, but not all, changes resemble breast cancer. ADH is found in about 5 percent of biopsies of breast calcifications, and it can also be found with a condition called atypical papilloma. If ADH is found, your doctor may recommend surgical excision of a small amount of additional tissue because there is a 20-35 percent chance that cancer could be present.

Atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS)

Atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) are not cancer, but are markers of increased risk of developing cancer in either breast. If you have ALH, your doctor may recommend six-month follow-up or surgical excision. For LCIS, your doctor may recommend a breast MRI and/or surgical excision of additional tissue at that spot.

What if my biopsy shows benign results?

Your radiologist will need to determine if your imaging results match with the pathology results. Most of the time, you can return to routine screening after a benign result on core needle biopsy. However, a repeat biopsy or surgical excision may be recommended in certain cases.

Why Choose UPMC for Stereotactic Breast Biopsy?

When you choose UPMC for stereotactic breast biopsy, you will receive:

Access to advanced imaging technology — Our experts use the latest imaging technology to quickly and accurately diagnose a full range of health conditions.
Convenient imaging services — Imaging appointments are available at multiple locations with hours that fit your schedule.
Multidisciplinary care — We partner with breast surgeons, medical oncologists, radiation oncologists, breast reconstructive surgeons, and other medical experts to treat breast cancer and other breast conditions.

By UPMC Editorial Staff. Last reviewed on 2025-08-28.

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