Case 22 Answer 2

The stereotactic biopsy was performed from above in a craniocaudal approach. This minimizes the distance traversed by the needle.

Other considerations when deciding the approach:

1. Is the finding seen much more easily on one of the views? Then the approach in that view may be necessary, even if the distance is farther.

2. Do anatomic conditions make only one approach possible?

3. Is a vessel overlying the finding in one of the views?

4. Does the patient have a strong preference for where the small potential scar might be located?

The biopsy yielded DCIS.  What is your recommendation now?

• 6 month mammograms to closely screen for an invasive tumor
• wire localization and surgical excision
• mastectomy