Vacuum Assisted Breast Biopsy in India

MRI GUIDED VABB

Dr. Jyoti Arora has been a pioneer in the implementation and refinement of MRI-guided VABB. Her expertise and dedication to advancing this technique have made significant contributions to the field of breast imaging.

What is MRI guided VABB?

Lumps or abnormalities in the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not always possible to tell from these imaging tests whether a growth is benign or cancerous. A breast biopsy is performed to remove some cells from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. This can be performed surgically or, more commonly, by a radiologist using a less invasive procedure that involves a hollow needle and image-guidance.

• Image-guided needle biopsy is not designed to remove the entire lesion but to obtain a small sample of the abnormality for further analysis.
• Image-guided biopsy is performed by taking samples of an abnormality under some form of guidance such as ultrasound, MRI or mammography.

In MRI-guided breast biopsy, magnetic resonance imaging is used to help guide the radiologist's instruments to the site of the abnormal growth. This is a simple and safe procedure, requires little recovery time and there is no significant scarring to the breast.

How Does It Work?

Unlike x-ray and computed tomography (CT) exams, MRI does not use radiation. Instead, radio waves re-align hydrogen atoms that naturally exist within the body. This does not cause any chemical changes in the tissues. A computer processes the signals and creates a series of images, each of which shows a thin slice of the body. These images can be studied from different angles by the radiologist.

MRI is able to tell the difference between diseased tissue and normal tissue better than x-ray, CT, and ultrasound. Using MRI guidance to calculate the position of the abnormal tissue and to verify the placement of the needle, the radiologist inserts the biopsy needle through the skin, advances it into the lesion, and removes tissue samples.

Benefits

• The procedure is less invasive than surgical biopsy, leaves little or no scarring, and can be performed in less than an hour.
• MRI does not involve exposure to radiation.
• MRI-guided breast biopsy using VABB is considered both safe and accurate.
• The speed, accuracy, and safety of MRI-guided vacuum-assisted breast biopsy are as good as MR-guided wire localization without the associated complications and cost of surgery.
• Compared with stereotactic biopsy, the MRI-guided method avoids the need for ionizing radiation exposure.
• MRI-guided breast biopsy, using the vacuum-assisted device, takes less time than surgical biopsy, causes less tissue damage, and is less costly.
• Recovery time is brief and patients can soon resume their usual activities.

Preparation

• Although MRI breast biopsy is minimally invasive, there is a risk of bleeding whenever the skin is penetrated. For this reason, you are advised to stop 3 days before the procedure. Please inform our staff if you have any known bleeding problems or have been taking blood thinners.
• Tell the technologist or radiologist if you have any serious health problem or allergy.

During The Test

After placement of an intravenous catheter in a vein in your arm, you will be positioned face down on the MRI table. Your breast to be biopsied will be placed through an opening in the breast coil on the MRI table and gently compressed to hold it still. MRI images will be taken to confirm that the lesion is still present. Then using computer imaging, the radiologist will locate and identify the specific area of the breast tissue to be biopsied.

Your breast will then be cleaned with an antiseptic. Next, the radiologist will numb the part of the breast to be biopsied by injecting local anesthetic with a tiny needle. You may feel some very brief stinging at this point. After the local anesthetic has taken effect, the radiologist will place a pre-biopsy sterile plastic tube into the breast to the site to be biopsied. MRI images will be obtained to confirm placement.

Once placement is confirmed, a special type of needle will be inserted into the hollow plastic tube. Then, the tissue samples (cores) are acquired. As the samples are taken, you may hear a humming from the biopsy instrument. After the radiologist has retrieved all of the desired samples, a tiny metal clip may be placed in your breast at the biopsy site. It is a very small, surgical-grade, titanium-based device designed to safely mark the biopsy site. You cannot feel it once it is placed in your breast. This clip will be used to localize the area if a further procedure is necessary. If nothing else is needed, the clip just remains in place and should not cause any problems.

How Long Will The Procedure Take?

The entire MRI biopsy procedure should take approximately one hour for one area of concern. Only a few minutes of that time will involve needle placement and tissue sampling; the majority of the time is taken up by MRI scanning.

After The Test

When the procedure is completed, pressure will be applied to the area for several minutes to prevent bleeding after which dressing is done. You will be taken to the mammography department and a mammogram of the biopsied breast will be performed to document the marker clip placement.

You will be provided written post biopsy breast care instructions prior to leaving the center. Most patients are able to resume their usual activities the next day.

Risks

• There is a risk of bleeding and forming a hematoma, or a collection of blood at the biopsy site. The risk, however, appears to be less than one percent of patients.
• An occasional patient has significant discomfort, which can be readily controlled by non-prescription pain medication.
• Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
• Depending on the type of biopsy being performed or the design of the biopsy machine, a biopsy of tissue located deep within the breast carries a slight risk that the needle will pass through the chest wall, allowing air around the lung that could cause the lung to collapse. This is an extremely rare occurrence.
• There is a very small chance that this procedure will not provide the final answer to explain the imaging abnormality.
• IV contrast manufacturers indicate mothers should not breastfeed their babies for 24-48 hours after contrast material is given.

Dr. Jyoti Arora, a leading radiologist in South Delhi, specializes in MRI-guided VABB (Vacuum Assisted Breast Biopsy), a minimally invasive procedure for precise breast tissue sampling. Dr. Jyoti Arora is one of the best in South Delhi for this advanced diagnostic technique.