Case Study: Upright Stereotactic Breast Biopsies

Upright breast biopsies can provide greater flexibility

For more than 20 years, Grapevine Radiology Associates has been providing cutting edge radiology services to patients in North Texas. During that time, the group made a commitment to deliver the highest standard of diagnostic care through state-of-the-art technology.

Among the challenges has been the ability to offer minimally invasive breast biopsy services to as many women as possible. To achieve that goal, Grapevine Radiology Associates uses the DBI Table, a breast biopsy table from Kansas City, Mo.-based Medical Positioning Inc. The table facilitates upright stereotactic breast biopsies using the decubitus position, which provides greater flexibility and optimal positioning, and enhances patient comfort.

Grapevine Radiology Associates has been using the DBI Table in conjunction with Hologic’s StereoLoc II upright stereotactic breast biopsy system for two years. For our facility, the table has the adaptability and stability that allows physicians to accommodate a wider array of patients. As far as I’m concerned, the DBI Table is an essential piece of equipment for performing successful biopsies on an upright stereotactic system.

Overcoming Limitations

The DBI Table overcomes many limitations of traditional prone tables. Decubitus positioning improves proximity to the procedure field and can improve access to lesions, such as those in the posterior and upper outer quadrants. In addition, decubitus positioning on the DBI table is more comfortable for patients, especially those with neck or spine problems.

The DBI Table enables physicians to position patients better with the “drop-out” sections of the table that can be lowered to access the patient. The drop-outs increase access to the breast and enable the shortest skin-to-lesion distance, regardless of lesion location or patient size. The table’s design accommodates difficult needle approaches – without repositioning the patient.

The drop-outs allow you to get the patient right up to the machine with no table interposed between the patient and the biopsy device, making it potentially easier to sample lesions that might be inaccessible on a traditional prone table. The C-arm can be rotated 90 degrees to approach the lesion from top to bottom without making the patient sit up – the areas of the table that are able to drop out make that possible.

The electrical height adjustment also improves patient access. The table can be raised or lowered based on a physician’s preference, which makes it easy to maneuver challenging patients and ensure a smooth procedure.

Increasing Patient Comfort

Patient comfort is always a concern during stereotactic biopsy procedures. Patients may be on the table from 15 minutes to 30 minutes, but the DBI Table ensures a positive patient experience regardless of the length of the procedure. In addition to the more comfortable decubitus position, the table has a detachable backrest that holds patients in place and alleviates strain during a procedure.

Allowing a patient to be positioned on her side is nearly always more comfortable than lying face down with the affected breast projecting through a hole as on prone stereotactic tables. I’ve had several patients who had been placed in the prone position for past stereotactic biopsy procedures, and they all say the DBI Table makes the procedure remarkably more comfortable and provoke less anxiety.

In addition, the DBI Table can handle a weight limit of 1,000 lbs. This enhanced stability allows clinicians to comfortably accommodate more patients, including those with physical limitations.

I’ve used other chairs or tables that have problems with stability, so if you get a patient close to the edge or too high on the chair, you’re in danger of tipping it. The DBI Table is completely stable and can be locked on all four corners, so there are no problems with instability.

Maximizing Efficiency

In addition to clinical benefits, using the DBI Table for stereotactic breast biopsies provides economic advantages. By using the table with an upright stereotactic add-on, centers can provide minimally invasive procedures to more women, while maximizing their mammography equipment and eliminating the need for a dedicated prone table and biopsy room.

The DBI Table, combined with the Hologic StereoLoc II upright stereotactic breast biopsy system, enables Grapevine Radiology Associates to perform successful stereotactic biopsies for a greater number of women. The table is a necessary piece of equipment that helps us provide the highest quality diagnostic care.

– Scott Woomer, MD, is a radiologist and president of Grapevine Radiology Associates in Grapevine, Texas. Direct questions and comments to editorial@rt-image.com.