Tomo guided biopsy in prone position

Dr. G. Saguatti. Radiologist, Director of the Breast Care Unit at Bellaria Hospital - Bologna Italy


In the realm of diagnostic imaging for breast cancer screening, two techniques of fundamental importance have been developed over the past fifteen years: stereotactic vacuum-assisted breast biopsy (VABB) and digital breast tomography (DBT).

It was clear right from the start that combining these methods would make it possible to achieve some important results, and not coincidentally technological research has for some time focused on applying DBT to VAAB.
However, until today this combination regarded solely biopsies performed with the patient sitting up (upright method), where the possibility of defining the biopsy target via tomosynthesis represents a significant help for the radiologist on some occasions, but with the inevitable persistence of patient discomfort (and consequent obstacles in diagnosis) tied precisely to the seated position.

The possibility of taking VABB samples with the patient in a prone position, guided by tomosynthesis imaging, certainly represents a perfect synthesis of the two methods. For the radiologist, this option – provided directly by the Giotto CLASS mammography unit and the complementary biopsy table FLEXITABLE – undoubtedly represents a further significant advance in the field of breast diagnostics.

Those who are familiar with the operating methods of VABB know very well that on some occasions the difference between basic mammography and scout view biopsy in terms of breast positioning, and above all the different method of breast compression, may create difficulties when it comes to identifying the target, particularly for small, non-microcalcified focal lesions and distortions.
Even in the hands of an expert operator, these difficulties can sometimes considerably complicate the sample taking procedure, if not preclude it altogether. Studying the target with tomosynthesis thus makes it possible to draw an overall picture, which becomes essential in the cases mentioned.
As always, it will be necessary to evaluate the clinical impact of the new method: indications, applications and limits. But today it is absolutely clear that the technological innovation embodied by Giotto CLASS corresponds to a significant step forward in the realm of diagnostics.