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 
biopsy specimen.

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.

Bob Richmond
Samurai Pathologist
Knoxville TN

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