The stereotactic core biopsy is performed on the Fischer Mammotest System.

Last month, Mary Doe had a mammogram that proved to be abnormal. Her physician sent her to a surgeon, who gave her the choice of the "wait-and-see approach, a repeat mammogram or a surgical breast biopsy.

Not wishing to face weeks of anxiety, Mary chose the surgical biopsy, during which she underwent general anesthesia. To Mary's relief, there was no malignancy. There was a recovery period during which she had to miss work. She had the expense of a surgical procedure, and now she has a scarred breast.

Jane Q. just received the news of an abnormal mammogram. This week she is scheduled for a stereotactic core biopsy procedure at the Breast Care Center, which is affiliated with Cape Girardeau Surgical Clinic Inc. There will be no delay in diagnosis.

Jane won't be required to have general anesthesia. She will have the procedure performed during her lunch hour and will miss no work. She won't have a recovery period or have to live with a scarred breast.

With the stereotactic core biopsy procedure, a needle is used instead of a knife. Breast-cancer testing is greatly simplified. The technique combines two technologies: a stereoscopic X-ray device that can pinpoint a mass within the breast and a needle that is used to extract tissue.

During the examination, the patient lies face down on a specially designed table with the breast placed through an opening in the table top. The physician performs the procedure from below. The breast is slightly compressed and held in position with a compression pedal just as it is during a mammogram.

A confirming X-ray is taken to identify the suspicious lesion. When the position is confirmed, stereo images which show the same area from different angles are taken. The exact positioning of the biopsy needle is calculated from these stereo images. A computer automatically transfers those coordinates to the side control of the procedure table.

The physician numbs the biopsy area with a local anesthetic and then advances the needle into the breast to acquire core samples that are sent for histologic interpretation. A dressing is applied to the biopsy site and the procedure is completed.

The patient can then walk out of the office and immediately resume her normal activities.

Dr. Robert Hunt, surgeon at Cape Girardeau Surgical Clinic Inc. is excited about the new procedure.

"For a long time, I have felt that physicians have performed too many biopsies that turned out to be benign," he said. "The reason we did that is the fear that we would miss a malignant one. Obviously, we want to detect cancers early. This new instrument will allow us to do biopsies on abnormalities at a third to a fourth of the cost, with a little two-millimeter incision, under local anesthetic, as an out-patient in our office."

Hunt said, "The accuracy is as good or better as an open biopsy. We think this new technique is a wonderful advance in the care of people with breast cancer. It is going to be the only such access between St. Louis and Memphis, and we are really excited about offering it to our patients."

Hunt said the stereotactic breast biopsy is used widely in cities such as Atlanta, where he went for training in the procedure.

Stereotatic biopsies are relatively new in the area of breasts. They have been used in brain surgery for several years.

Hunt thinks the new procedure will be widely used in medicine in the future.

Sarah J. Holt, clinic administrator at Cape Girardeau Surgical Clinic, said, "Stereotactic core biopsy is a revolutionary new alternative to surgical biopsy. It is not in the experimental stage. It has been clinically proven to be as accurate as surgical biopsy in diagnosing breast disease. The procedure provides a definite diagnosis 99 percent of the time."

It is important women take advantage of new technologies being developed for detecting and treating breast disease, which will strike one in eight women in their lifetimes. Early detection greatly increases the likelihood of recovery.

Physicians recommend women have regular mammograms. One of five breast cancer deaths may have been prevented had patients had mammograms for early detection.

Women should also examine their breasts monthly to search for potential problems.

There are several factors that increase breast cancer risk. One factor is age. About 80 percent of all breast cancers occur in women older than 50.

Women whose mothers, sisters or daughters have or have had the disease are at greater risk.

Those who stated to menstruate before age 12, experienced a late menopause (after 55), or had their first child after the age of 30 or never had a child also are at greater risk.

While it is important to keep a close watch on changes in your breast, a large percentage (about 80 percent) of the abnormalities found are benign and present no health risk to the patient.

Every year, some 500,000 women undergo breast biopsies. Many still endure the trauma of surgery, but an alternative is finally at hand.

"There's no doubt in my mind that the majority of breast biopsies will be done this way in the future," said Dr. Steve Parker, the Denver radiologist who pioneered the new method. As women become aware of this option, they're not going to settle for the status quo."