Role of Stereotaxis in Diagnosis and Treatment of Breast Tumors

Abstract

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.