0:00

Why would we specifically use Mammographic guidance

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rather than ultrasound or MRI guidance?

0:07

Well, there are findings that are solely

0:09

seen on mammography.

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Typically, these are calcifications.

0:13

However, there are some masses, asymmetries

0:16

and distortions that are sono graphically occult.

0:19

And so we default to using mammography for guidance

0:22

of the percutaneous biopsy.

0:25

There are some advantages for using mammographic guidance.

0:28

Um, does not require contrast. It uses available technology.

0:32

In fact, there are some, uh, mammographic guided machines

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that are add-on to a typical mammogram unit

0:38

and don't require a special room.

0:42

Um, also we have the advantage of specimen radiography

0:46

for targets of calcifications,

0:48

which can confirm satisfactory sampling.

0:51

Some of the disadvantages of using mammography

0:54

or guidance include discomfort for the patient.

0:56

I'll be showing you pictures of

0:58

what the biopsy tables look like

1:00

and they're pretty uncomfortable.

1:01

Um, does require radiation lesions near the chest wall

1:06

or in a smaller thin breast may not be amenable

1:09

to biopsy under mammographic guidance.

1:12

We also don't have the realtime visualization

1:14

of needle in the target, uh, which you would have

1:17

with ultrasound guidance.

1:19

Um, and also if the target is noncalcified, there's no way

1:23

to confirm with the specimen radiograph

1:25

that you've been successful.

1:28

Overall, mammographic guided core biopsies are less

1:32

preferable than using ultrasound,

1:33

but more preferable than utilizing MRI.