Image-guided core needle biopsy of breast masses has been one of the most helpful and significant developments in the diagnosis of breast cancer. Under local anesthesia in the office, Dr. Ley uses the Vacora (TM) handheld 10guage rotating cutting needle to sample breast masses under ultrasound guidance. Patients tolerate the procedure well, and most have their pathology reports in less than 72 hours. The Vacora device produces a specimen large enough (100-150mg) for accurate diagnosis and biomarker (ER/PR/Her2neu) analysis compared to the smaller specimens obtained with standard 14 guage core biopsy (20mg), yet avoids the higher risk of postprocedure hematoma associated with larger 8 guage mammotome needles. Avoiding open excisional biopsy often allows a more cosmetic breast conserving operation or skin-sparing mastectomy while permitting proactive planning to optimize surgical margins. www.bardbiopsy.com

Used for lesions that are identified only by mammography, such as nodular densities and suspicious calcifications, stereotactic biopsy is performed under local anesthesia, often on the same day as your office visit. This procedure carries the same advantages as minimally-invasive ultrasound-guided biopsy in terms of cosmesis and surgical planning. Recovery time is minimal and the procedure is very well tolerated.

Much like image-guided core needle biopsy, the Rubicor Ovation (TM) device uses a percutaneously inserted image-guided radio frequency loop to completely excise small lesions under local anesthesia in the office. For use in selected patients, the Ovation does use heat energy to coagulate blood vessels and is not appropriate for lesions close to the skin or chest wall.