Breast Health Centre home to only machine of its kind in province
Stereotactic breast biopsy machine alleviates stress on patients and system
Winnipeg Health Region
Published Monday October 4, 2010
The Breast Health Centre has just taken delivery of a new stereotactic breast biopsy machine - a key tool in the diagnosis and treatment of breast cancer.
The Siemens Mammotest Stereotactic Prone Table cost about $300,000, and will be used to do about 12-15 biopsies a week, says Dr. Murray Wilson, Imaging Director at the Breast Health Centre.
A biopsy is a procedure in which tissue is taken from a suspicious growth in order to determine if it is cancerous. In the past, biopsies were accomplished by lumpectomy, which involves the surgical removal of all or some of the growth. A stereotactic biopsy offers a less-invasive alternative.
"The stereotactic machine allows us to biopsy a breast lesion which is seen on a mammogram but can not be felt or seen with ultrasound. We get an accurate diagnosis without a lumpectomy," Wilson says. The procedure is quick to perform, minimally invasive, associated with rapid patient recovery, and has very few complications.
Here is how it works.
A patient is positioned face down on a table, which can be easily moved as needed. The table has a hole that their breast fits into. The breast is then compressed in a mammography machine and imaged from two angles.
Using digital imagery on a computer screen, the radiologist determines where to obtain the sample from the patient's breast. A specialized probe is used to obtain multiple samples for pathology analysis. This technique is typically used when lumps cannot be felt or seen with ultrasound.
The entire procedure takes about 30 minutes. Recovery time is usually 24 hours and typically involves an ice pack and Advil instead of suturing and scarring.
Wilson says the new machine has faster operating software and a flat panel, high resolution monitor that offers sharper images than the older model it is replacing. "It's quite a bit faster so you can complete the procedure quicker which tends to cut down on possible complications," he says.
The stereotactic biopsy machine is just one of the tools used by the Breast Health Centre to provide better care for women. The team at the centre, which includes three radiologists and two technologists, also uses ultrasound exams in their fact finding mission when examining a lesion's characteristics.
Wilson and his colleagues perform about 50 ultrasound exams per week. Because the Radiologist does the ultrasound at the Breast Health Centre, they can do the biopsy if necessary at the same visit.
"When we look at an ultrasound image, we are looking for cancer. If we find something immediately, we can act on it immediately, which alleviates some stress for the patient," says Wilson. "It's very common for a woman to feel anxiety when they feel a lump or have a mammogram that may require follow up. They often think the worst and if we can prove it's benign at that moment, it's a huge relief to them."
The majority of cases - as high as 80 per cent - assessed through the Breast Health Centre's radiology team are benign. Wilson says these are the target numbers he and his team want to see. "If you have higher malignancy rates you may be ignoring significant changes on the mammogram."
In follow up, there are constant opportunities to learn when reviewing the imaging findings and pathology report. Wilson says, "It becomes engrained in our mind how the specific process presented and appeared on the imaging tests, and what the pathology is."
It's having this impact on people's lives that inspired Wilson to get involved in breast imaging over a decade ago. From his perspective, breast imaging in the province was severely lagging behind our counterparts across the country. "Ultrasounds were only available in hospitals and we had no stereotactic equipment," he says.
That's why Wilson went to San Francisco to get additional training with one of the top mammography experts in the world, Dr. Ed Sickles. It was there he became interested in how to improve things. He also received training from Dr. Steve Parker in Denver Colorado, who is a leading expert in breast ultrasound, core biopsies and stereotactic biopsies.
Wilson's voice in the planning stages of the Breast Health Centre and subsequent decade plus of involvement have helped create an environment where high quality, leading edge patient care is the norm for the patients the Breast Health Centre serves.