Background: Stereotactic/tomosynthesis guided breast biopsy uses mammography to guide biopsy of lesions seen mammographically. Standard sterotactic/tomosynthesis guided biopsy uses a vertical-approach needle insertion in which the needle is perpendicular to the compression plate. The lateral side arm device which has been developed more recently, allows procedures to be performed using a needle insertion parallel to the compression plate. This has some advantages for certain patients and lesions. Since this technique is newer, many radiologists many be less familiar and comfortable with it's use.
Learning Objectives: 1. Describe and illustrate the mechanism and equipment used during the lateral side arm breast biopsy procedure. 2. Detail the steps in a lateral arm procedure for both the prone biopsy system and the upright add on system. 3. Compare and contrast the risks and benefits of the lateral side arm device with the standard mammography guided biopsy. 4. Summarize tips and tricks when using the lateral side arm device.
Abstract Content/Results: A detailed review of the lateral side arm breast biopsy procedure will be given. First, the equipment used and mechanism of the devices for both the prone and upright units will be described in detail - using pictures and illustrations. A step by step guide to preforming the procedure will be given for both systems using pictures of a model patient or phantom to illustrate important concepts. A discussion about the indications of use will be given including accessing lesions in a thinly compressed breast, biopsy of posterior lesions, and advantage of being able to see the target in the aperture. Then, a tips and tricks section from our own experience and the literature will be provided. Many case examples will be given. At our health system, several breast biopsy manufacturers are used. Therefore, devices from different manufacturers will be included.
Conclusion: Sterotactic/Tomosynthesis guided breast biopsy using the lateral arm device allows a new approach to perform biopsy procedures. It has improved patient care by allowing radiologists to biopsy areas which previously were unable to be biopsied with the standard technique. However, the technique is new and therefore a review of the technique and equipment will allow radiologists to become more comfortable with it's use.
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