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Breast biopsy

Stereotactic Biopsy — for Breast Calcifications

If your mammogram showed calcifications and your doctor has recommended a biopsy, this page explains what happens step by step and what to expect on the day.

Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed September 2026

  • Mammogram-guided precision — X-ray images from two angles locate the exact cluster and guide the needle to it.
  • The position is the hard part — Lying face-down with your breast through a table opening is unfamiliar. The needle itself is well tolerated by most women.
  • Quick sampling — The actual tissue collection takes only a few minutes once you are in position.
  • Most calcifications are benign — The biopsy exists to confirm which group yours falls into — not because the outcome is assumed to be serious.
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A stereotactic biopsy samples breast calcifications that appear on a mammogram by using X-ray images to guide a needle to the exact spot. The hardest part for most women is the face-down table position, not the needle. The sampling takes a few minutes; most appointments are done within an hour.

Why do calcifications on a mammogram need a biopsy?

Calcifications are tiny calcium deposits that appear as white specks on a mammogram. Most form in normal breast tissue and are completely harmless.

A small number of calcification clusters can be associated with early cell changes. Imaging alone cannot tell the difference — the pattern and grouping on the mammogram tells a radiologist a cluster warrants closer investigation, but only a tissue sample can give a clear answer.

A recommendation for biopsy is not confirmation that something is wrong. It is the most direct way to find out whether the calcifications need any further attention.

What do these medical terms mean?

Calcifications
Tiny calcium deposits that appear as white specks on a mammogram. They are not related to dietary calcium or supplements.
Stereotactic guidance
A system that uses mammogram images taken from two different angles to calculate the exact position of a calcification cluster and guide the biopsy needle to it.
Vacuum-assisted biopsy
The technique most often used for calcifications. A small probe uses gentle suction to draw tissue into a sampling notch, collecting several small core samples in one pass.
Prone table
The purpose-built table you lie face-down on. Your breast rests through an opening in the surface so it can be held still and positioned for the X-ray system below.
Titanium clip
A small marker placed at the biopsy site before you leave. It shows the exact location on any future mammogram or MRI. It causes no discomfort and cannot be felt.

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What does the procedure actually feel like?

The position is what surprises most women. You lie face-down on the prone table with your breast through an opening below, and you need to stay still for around fifteen to twenty minutes. This is unfamiliar and can feel slightly uncomfortable, but it is not painful.

Before the needle is inserted, the skin and surrounding tissue are numbed with a local anaesthetic. Most women feel a brief sting from the injection and little else after that. You will hear a clicking sound as each tissue sample is removed.

After sampling, a small titanium clip is placed to mark the site, a final mammogram confirms its position, and firm pressure is applied for several minutes. You leave with a dressing and instructions for the next day or two.

Did you know?

The majority of breast biopsies return a benign result.

A recommendation to biopsy reflects caution about an imaging pattern — not a presumption that the result will be serious. The biopsy exists to replace uncertainty with a clear answer.

Source: American Society of Breast Surgeons: evidence-based guidelines on diagnostic breast biopsy

What else should I know before the day?

What is the prone table and why do I have to lie face-down?

The prone table is designed specifically for stereotactic biopsy. Lying face-down allows your breast to rest through an opening in the table surface, separating it from your chest wall and holding it still for the X-ray imaging system positioned below. This setup gives the radiologist clear access and precise guidance without needing to ask you to hold a difficult position with your arms. The table can be firm, and the position feels unusual. Letting the radiographer know if you are uncomfortable, or if you need a moment to adjust, is always fine. The team performs this procedure regularly and is used to helping women settle in.

Will I feel the needle going in?

The skin and deeper tissue are numbed with a local anaesthetic before any sampling begins. Most women feel the brief sting of the anaesthetic injection — this lasts a few seconds — and then pressure or mild discomfort as the probe is inserted, but not the sharp sensation of the needle itself. You will hear a clicking sound each time a sample is removed. If you feel more than mild discomfort at any point during the procedure, say so immediately so the team can give additional anaesthetic before continuing.

Why is a clip left inside my breast?

The titanium clip marks the exact spot where the biopsy was taken. Once the tissue has been disturbed by a biopsy, the calcifications in that area can be harder to locate again on imaging. The clip ensures the site can be found precisely for any follow-up that is needed — whether a surveillance mammogram, an MRI, or surgery. The clip is very small, causes no discomfort, cannot be felt through the skin, and does not affect most metal detectors. It remains permanently, but it is harmless. If surgery is later recommended, the surgeon uses the clip to locate the correct area.

What should I expect in the days after?

Bruising and mild tenderness at the biopsy site are normal and may last several days. Most women manage this with paracetamol and a supportive bra. You will be asked to keep the dressing dry for the first day or two and to avoid heavy lifting or vigorous exercise for a short period. The bruising may look more obvious after twenty-four hours before it begins to fade — this is expected. Contact your team rather than waiting if you notice increasing swelling, bleeding that soaks through the dressing, or any fever in the days following the procedure.

What if I cannot hold the position for that long?

Tell the radiographer before the procedure begins if you have a back condition, shoulder pain, or any health issue that makes lying face-down difficult for an extended time. In some situations, the approach can be adjusted or additional padding arranged to make the position more manageable. It is far better to raise this beforehand than to attempt the procedure and find you cannot hold the position once you are on the table. There is no judgment in saying you are anxious or in pain — the team wants the experience to be manageable for you and has helped many women in similar situations.

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Common questions

Frequently asked questions

How soon will I get my results?

Results are typically available within a week, though the exact timing depends on the laboratory and your centre. Your team will tell you at the appointment how and when you will receive the result — ask specifically if it is not mentioned. Results are generally not given over the phone, so you may be asked to come back for a short appointment. If the wait is difficult, ask on the day exactly what the timeline is and who to contact if you have not heard by the expected date.

Can I eat and drink normally before the procedure?

Yes. There is no requirement to fast before a stereotactic biopsy because it uses local anaesthetic, not general anaesthetic. Take any regular medicines as usual unless your team has told you otherwise. If you are on blood-thinning medication such as warfarin or aspirin, tell your team before the appointment — they may ask you to pause it for a short time beforehand, depending on your dose and reason for taking it.

Are there any risks I should know about?

Bruising and mild tenderness are the most common effects and usually settle within a week. Infection is uncommon. Significant bleeding during or after the procedure is rare. There is a small possibility that the needle may not collect the specific calcifications being investigated, and if the pathology result is not conclusive, your team may recommend a repeat biopsy or further imaging. The titanium clip is left to allow any follow-up imaging to locate the site accurately.

What do I do if bleeding does not stop after I get home?

Apply firm, steady pressure over the dressing with a clean cloth for at least ten to fifteen minutes without lifting to check. If firm pressure for this length of time does not slow the bleeding, or if the area is swelling rapidly, go to your nearest emergency department rather than waiting for a callback. Minor ooze through the dressing in the first few hours is normal. Before you leave, your team will tell you exactly what warrants a call versus what to expect as a normal part of recovery.

Does the titanium clip affect future MRI scans?

No. The titanium clip used in breast biopsy is MRI-compatible and will not interfere with the scan or cause any discomfort during it. It will appear on the MRI image as a small marker, which is exactly what it is designed to do. If you are asked to fill in a metal implant questionnaire before any future MRI, note the biopsy clip — the radiographer will be familiar with it. The clip does not set off airport detectors or create any problem in daily life.

Will I need further treatment after the biopsy?

That depends entirely on what the pathology report shows. If the result is benign, the usual recommendation is continued mammogram surveillance on a schedule your team will advise. If the result shows an abnormality that needs attention, your oncologist or breast surgeon will explain the options clearly — what each involves and what it is intended to achieve. The biopsy result is the starting point for that conversation, not a predetermined outcome. Most women who have this biopsy receive reassuring news.

Full index

Browse all 701 biopsy topics

Every page in this section, grouped by the part of the journey it belongs to. Pick a group to see what is in it.

What Is a Biopsy?

What Is a Biopsy? Everything You Need to Know →

Types of Biopsy Compared

Which Biopsy Will You Have? Techniques Compared →

Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

After a Biopsy: Recovery, Aftercare and Warning Signs →

Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

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IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

Cytology & Prostate Scoring Systems Explained →

How Accurate Is a Biopsy?

How Accurate Is a Biopsy? Errors and Second Opinions →

If Your Result Is Benign

Your Biopsy Is Benign: What It Means and What Comes Next →

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