Decubitus positioning for stereotactic core biopsy

Full text

Digital stereotaxis has made biopsy of microcalcifications more effective. Results with the upright units mainly available in the UK have been shown to be comparable with those obtained on dedicated prone biopsy tables. Some women suffer vasovagal attacks while in the sitting position and this complication led us to develop the decubitus method, in which the woman lies on her side on a trolley. The breast to be biopsied is positioned uppermost and entered from a lateromedial approach. The woman can be rolled towards the prone position until the sternum touches the edge of the grid. This position has been found to be stable and comfortable for the patient. It allows easy access to the breast and allows posterior lesions to be reached. An alternative mediolateral approach is possible with the affected breast inferior and the upper breast taped back, with the patient in an anterior oblique position. These methods have proved valuable for "fainters" and for disabled women, including those with severe shoulder and neck arthritis. Because of the increased operator and patient comfort, we are tending to adopt this method for all stereotactic core biopsies.