Sonographically guided vacuum-assisted breast biopsy using handheld mammotome.

Sonographic examination of the breast with state-of-the-art equipment has become an essential part of the clinical work-up of breast lesions and a valuable adjunct to mammographic screening and physical examination (Stavros et al. 1995). The technique is capable of detecting lesions not seen on mammography, allowing differentiation of cystic from solid lesions, and benign from malignant lesions. Because of the real-time capabilities and the high spatial and contrast resolution, sonography has become the optimal guidance technique for percutaneous interventional procedures and preoperative localization of nonpalpable lesions. Fine-needle aspiration (FNA) and core-needle biopsy (CNB) are long-established valuable techniques, still used in the majority of cases; vacuum-assisted biopsy (VAB) is a more recent technique with proven clinical value, which can be used under sonographic, mammographic, and magnetic imaging resonance (MRI) guidance. The purpose of this chapter is to describe the technique of sonographically guided Mammotome biopsy.