Breast Cancer pp 149-154 | Cite as

Role of Stereotaxis in Diagnosis and Treatment of Breast Tumors

  • Kambiz Dowlatshahi
  • Anna Katz


Breast stereotaxis developed by a Swedish radiologist and a Finish engineer was first deployed in early 1980s as a clinical tool in Karolinska Institute in Stockholm, Sweden. Its emergence as a diagnostic device followed the popularization of screening mammography for early detection of breast cancer (Moskowiz Am J Roentgenol 136:735–738, 1981; Baker CA Cancer J Clin 32:194–225, 1982; Spivey et al. Am Surg 48:326–332, 1982). Women with mammographic abnormalities underwent wire localization and open biopsy for diagnosis of cancer when an abnormality was detected. Only 20 % of these shadows were proven to be malignant on subsequent histologic examination. Thus four of five patients underwent stressful experience of unnecessary surgery and associated cost. In 1985 the author (KD) travelled to Karolinska, evaluated the technology, and learned its application. The Swedish investigators reported on 2,594 patients whose breast lesions had been biopsied with a fine needle and noted suspicious lesions in 22.7 % of cases. Subsequent excisional biopsy proved the true positives to be 17.5 %. The author then observed its utility by a gynecologist at the University of Kiel in West Germany who reported on 528 patients with an accuracy of 92 %. The technology was then introduced into the United States at the University of Chicago.


Breast Lesion Dense Breast Breast Biopsy Positron Emission Mammography Magnetic Resonant Imaging 
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  1. 1.
    Nordenstrom B, Zajicek J. Sterotaxic needle biopsy and preoperative indication of nonpalpable mammary lesions. Acta Cytol. 1977;21:350–1.PubMedGoogle Scholar
  2. 2.
    Moskowiz M. Mammographic screening: significance of minimal breast cancers. Am J Roentgenol. 1981;136:735–8.CrossRefGoogle Scholar
  3. 3.
    Baker L. Breast cancer detection demonstration project: five-year summary report. CA Cancer J Clin. 1982;32(4):194–225.PubMedCrossRefGoogle Scholar
  4. 4.
    Spivey G, Perry B, et al. Predicting the risk of cancer at the time of breast biopsy. Am Surg. 1982;48:326–32.PubMedGoogle Scholar
  5. 5.
    Bassett L, Liu TH, et al. The prevalence of carcinoma in palpable vs impalpable, mammographically detected lesions. Am J Roentgenol. 1991;157:21–4.CrossRefGoogle Scholar
  6. 6.
    Azevado E, Svane G, et al. Stereotactic fine-needle biopsy in 2594 mammographically detected non-palpable lesions. Lancet. 1989;1:1033–6.CrossRefGoogle Scholar
  7. 7.
    Dowlatshahi K, Gent H, et al. Nonpalpable breast tumors: diagnosis with stereotaxic localization and fine-needle aspiration. Radiology. 1989;170(2):427–33.PubMedGoogle Scholar
  8. 8.
    Dowlatashahi K, Yaremko ML, et al. Nonpalpable breast lesions: findings of stereotaxic needle-core biopsy and fine-needle aspiration cytology. Radiology. 1991;181(3):745–50.Google Scholar
  9. 9.
    Parker SH, Lovin JD, et al. Nonpalpable breast lesions: stereotactic automated large-core biopsies. Radiology. 1991;180:403–7.PubMedGoogle Scholar
  10. 10.
    Parker SH, Burbank F, et al. Percutaneous large-core breast biopsy: a multi-institutional study. Radiology. 1994;193:359–64.PubMedGoogle Scholar
  11. 11.
    Helbich TH, Rudas M, et al. Evaluation of needle size for breast biopsy: comparison of 14-, 16-, and 18-gauge biopsy needles. Am J Roentgenol. 1998;171:59–63.CrossRefGoogle Scholar
  12. 12.
    Whitlock J, Evans A, et al. Digital imaging improves upright stereotactic core biopsy of mammographic microcalcifications. Clin Radiol. 2000;55(5):374–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Becker L, Taves D, et al. Stereotactic core biopsy of breast microcalcifications: comparison of film versus digital mammography, both using add-on unit. Am J Roentgenol. 2001;177: 1451–7.CrossRefGoogle Scholar
  14. 14.
    Reynolds HE, Poon CM, et al. Biopsy of breast microcalcifications using an 11-guage directional vacuum assisted device. Am J Roentgenol. 1998;171:59–63.CrossRefGoogle Scholar
  15. 15.
    Pfarl G, Helbich TH, et al. Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study. Am J Roentgenol. 2002;179:1503–7.CrossRefGoogle Scholar
  16. 16.
    Helbich TH, Matzek W, et al. Stereotactic and ultrasound-guided breast biopsy. Eur Radiol. 2004;14:383–93.PubMedCrossRefGoogle Scholar
  17. 17.
    Saslow D, Boetes C, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.PubMedCrossRefGoogle Scholar
  18. 18.
    Bkeicher RJ, Morrow M. MRI and breast cancer: role in detection, diagnosis, and staging. Oncology. 2007;21(12):1521–8.Google Scholar
  19. 19.
    Heywang-Kobrunner SH, Bick U, et al. International investigation of breast MRI: results of a multicentre study (11 sites) concerning diagnostic parameters for contrast-enhanced MRI based on 519 histopathalogically correlated lesions. Eur Radiol. 2001;11:531–46.PubMedCrossRefGoogle Scholar
  20. 20.
    Berg WA, Madsen KS, et al. Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 2007;258(1):59–72.CrossRefGoogle Scholar
  21. 21.
    Burbank F, Parker SH, et al. Stereotactic breast biopsy: improved tissue harvesting with the mammotome. Am Surg. 1996;62:738–44.PubMedGoogle Scholar
  22. 22.
    Dowlatshahi K, Francescatti DS, et al. Laser therapy for small breast cancers. Am J Surg. 2002;184:359–63.PubMedCrossRefGoogle Scholar
  23. 23.
    Burak WE, Agnese DM, et al. Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision. Cancer. 2003;98(7):1369–76.PubMedCrossRefGoogle Scholar
  24. 24.
    Sabek MS, Kaufman CS, et al. Cryoablation of early-stage breast cancer: work-in-progress report of a multi-institutional trial. Ann Surg Oncol. 2004;11(5):542–9.CrossRefGoogle Scholar
  25. 25.
    Bloom KJ, Dowlat K, et al. Pathalogic changes after interstitial laser therapy of infiltrating breast carcinoma. Am J Surg. 2001;182(4):384–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of General SurgeryRush University Medical CenterChicagoUSA
  2. 2.Advocate Condell Medical CenterLibertyvilleUSA

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