https://my.clevelandclinic.org/health/diagnostics/24204-breast-biopsy-overview

Core perspective: From the perspectives of patient care and medical safety, this article elaborates on the preoperative preparations for stereotactic biopsy, the management of intraoperative comfort, postoperative care, and how to prevent and handle potential complications such as bleeding, pneumothorax, and infection through standardized operations.

Although breast stereotactic biopsy is a minimally invasive technique, the psychological stress and physiological sensations of patients cannot be ignored either. Optimizing the entire process management, enhancing the patient experience, and ensuring the safety of the operation are important indicators for evaluating the level of a hospital's breast diagnosis and treatment center.

Preoperative communication and preparation:

Adequate informed consent is of utmost importance. Doctors should explain the operation procedures, purposes, and possible risks (such as local hematoma, pain, and a very low probability of pneumothorax) in plain language. For highly anxious patients, short-acting sedatives can be used as appropriate. Before the operation, anticoagulant drugs (such as aspirin, warfarin) should be discontinued for at least 5-7 days, and it should be confirmed that the patient has no coagulation dysfunction. For lactating or pregnant patients, the benefits and risks should be weighed and the guiding method with the lowest radiation dose (such as ultrasound or MRI) should be selected.

Intraoperative comfort and cooperation:

Local anesthesia is crucial. Using lidocaine containing epinephrine not only provides pain relief but also constricts blood vessels and reduces bleeding. When injecting the anesthetic, it should be done slowly and in layers to ensure full infiltration of the skin, subcutaneous tissue, and breast tissue. For stereotactic biopsy, patients need to remain in a prone position or sit in a fixed position for up to 20-30 minutes. Comfortable positioning pads and timely verbal reassurance can effectively alleviate discomfort. The operating doctor should perform gentle and precise movements, avoiding violent punctures.

Postoperative management and complication prevention:

• Bleeding and hematoma: The most common complication. Immediately apply pressure with your palm at the puncture site for 10-15 minutes after the operation. Ice application can effectively reduce exudation. Small hematomas can be absorbed on their own, while large hematomas require aspiration under ultrasound guidance or incision and drainage. The built-in flushing function of the vacuum-assisted biopsy helps to clear accumulated blood.
• Infection: Strict aseptic operation is the key to prevention. Keep the puncture site dry for 24 hours after the operation. Diabetic patients or those with low immunity may consider taking prophylactic oral antibiotics.
• Pneumothorax: Rare but serious. It mainly occurs at the axillary tail or in patients with extremely thin chest walls. During the operation, ensure that the needle tip is at a safe distance from the pleura by ultrasound or X-ray confirmation. Avoid vertical needle insertion. Once pneumothorax occurs, immediately stop the operation, closely observe, and perform closed thoracic drainage if necessary.
• Pain and syncope: Some patients may experience vasovagal reactions (dizziness, sweating, and slowed heart rate). Have the patient lie flat, raise the lower limbs, and provide oxygen. Most cases can be relieved on their own.

Follow-up and result notification:

After the biopsy, it is necessary to clearly inform the patient when to receive the pathological report. For patients with benign results, it is recommended to conduct regular follow-ups; for those diagnosed with malignancy or atypical hyperplasia, a multidisciplinary consultation should be initiated as soon as possible to formulate a subsequent treatment plan. A complete closed-loop management not only resolves the diagnostic issue but also provides patients with continuous security and trust.

Through the above five articles, we have comprehensively analyzed this key technology of breast stereotactic biopsy from five dimensions: technical principles, clinical applications, precision medicine, equipment integration, and patient safety. We hope these contents can provide you with valuable industry insights.