What's a Mammotome?
Jacquie Mack in Canada asks: What's a Mammotome?
The Fisher Suction Mammotome (that's the correct spelling) is a prone-table
stereotactic localization device, used to biopsy lesions in the breast seen
on mammography, either masses or foci of calcification. The patient lies
prone on a table with her breast hanging through a hole in the table. A
mammographic X-ray unit finds the lesion, and using this information the
radiologist or surgeon inserts a biopsy needle into the mass, often
repeatedly, removing large cores of tissue until the calcification is
identified by specimen radiography of the cores.
The cores are immediately fixed in formalin. Some services arrange five
specimens, a center specimen and the quadrants around it, while other
services separate cores containing calcifications from the rest. If
calcifications are sought, the pathologist should receive a specimen
radiogram, just as would be (or should be) done with a wire localization
Sections of these cores usually - there are a number of pitfalls in
pathologic diagnosis with them - provide an unequivocal diagnosis of cancer
or benign disease. Immune stains and DNA studies can be done on the core
The advantages to the patient are obvious. No anesthesia is required, and
there is no surgical incision or scar. (I have observed a number of these
procedures, and to the observers eye the procedure does not appear to be
strikingly painful.) Almost all of the pathologic information needed to plan
treatment is obtained without anything bigger than a needle biopsy having
been done to the patient, so that treatment protocols are not compromised and
the patient has the widest possible choice of treatments.
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