Prone position stereotactic mammography needle biopsy apparatus and method for using the same

• US 5,609,152 A
• Filed: 02/15/1995
• Issued: 03/11/1997
• Est. Priority Date: 11/27/1991
• Status: Expired due to Term

• Current Assignee: Hologic Incorporated
• Original Assignee: Thermotrex Corporation (Thermo Fisher Scientific Incorporated)
• Inventors: Storm, Jeffrey R., Stoller, Milton, Schutz, Richard F., Camarra, David D., Scandura, Anthony M., DeFreitas, Kenneth F., Pellegrino, Anthony J.
• Primary Examiner(s): Lateef, Marvin M.
• Assistant Examiner(s): Casler, Brian L.
• Application Number:
  US08/388,810
• Time in Patent Office: 755 Days
• Field of Search: 128/653.1, 128/662.05, 128/754, 606/130, 378/37, 378/87, 378/68, 378/208, 378/193, 378/195, 378/196, 5/601
• US Class Current: 600/429
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 6/0435 with means for imaging suspended breasts
• CPC Class Codes: A61B 6/4488 Means for cooling A61B6/045 takes precedence
• CPC Class Codes: A61B 6/502 for diagnosis of breast, i.e. mammography
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/17 for soft tissue, e.g. breast-holding devices

Abstract

A patient-supporting table for performing prone stereotactic mammographic biopsy procedures having a platform with an aperture positioned so as to divide the platform into two supporting portions is disclosed. Each of the supporting portions of the platform are sufficient to support at least a patient'"'"'s torso and legs. The supporting portions of the platform enable a patient'"'"'s breast to be pendulantly presented in two different orientations with respect to the aperture which further enables 360° access to a pendulantly presented breast by stereotactic mammography and biopsy apparatus which have rotation ranges substantially less than 360° but more than 180° relative to the aperture.

Claims

1. A patient-supporting table for performing prone stereotactic mammographic biopsy procedures, the table comprising:

a platform having a first end, a second end, and a breast-receiving aperture permitting pendulant presentation of a patient'"'"'s breast therethrough, wherein the breast-receiving aperture is positioned on the platform so as to divide the platform into a first supporting portion extending from the first end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a first patient position and a second supporting portion extending from the second end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a second patient position.

whereby supporting a patient on the first supporting portion of the platform in the first patient position enables the patient'"'"'s breast to be pendulantly presented in a first orientation through the breast-receiving aperture of the platform and whereby supporting a patient on the second supporting portion of the platform in the second patient position enables the patient'"'"'s breast to be pendulantly presented in a second orientation through the breast-receiving aperture of the platform.

2. The patient-supporting table of claim 1 further comprising a concave torso depression surrounding the aperture in the platform.

3. The patient-supporting table of claim 1, wherein the first supporting portion of the platform is provided with an extensible and retractable footrest, and the second supporting portion of the platform is provided with an extensible and retractable footrest.

4. A prone stereotactic mammographic biopsy apparatus for performing stereotactic X-ray guided breast biopsies comprising:

a base;

a pedestal extending upwardly from the base;

a platform supported by the pedestal, the platform having a first end, a second end, and a breast-receiving aperture permitting pendulant presentation of a patient'"'"'s breast therethrough, wherein the breast-receiving aperture is positioned on the platform so as to divide the platform into a first supporting portion extending from the first end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a first patient position and a second supporting portion extending from the second end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a second patient position;

a positionable ledge extending outwardly from the pedestal below the patient-supporting platform;

means for obtaining stereotactic X-ray images of the patient'"'"'s breast pendulantly presented through the breast-receiving aperture in the patient-supporting platform, the means being supported by the positionable ledge;

means for compressing the pendulantly presented breast, the means being supported by the positionable ledge; and

means for guiding a biopsy needle into the pendulantly presented and compressed breast, the means being supported by the positionable ledge;

whereby supporting a patient on the first supporting portion of the platform in the first patient position enables a patient'"'"'s breast to be pendulantly presented through the breast-receiving aperture in a first orientation with respect to the breast-receiving aperture and means for obtaining stereotactic X-ray images, means for compressing the breast and means for guiding a biopsy needle, and whereby supporting a patient on the second supporting portion of the platform in the second patient position enables the patient'"'"'s breast to be pendulantly presented through the breast-receiving aperture in a second orientation with respect to the breast-receiving aperture and means for obtaining stereotactic X-ray images, means for compressing the breast and means for guiding a biopsy needle.

5. The apparatus of claim 4, further comprising a concave torso depression surrounding the aperture in the platform.

6. The apparatus of claim 4, wherein the first supporting portion of the platform is provided with an extensible and retractable footrest, and the second supporting portion of the platform is provided with an extensible and retractable footrest.

7. The apparatus of claim 4, wherein the pedestal includes means for adjusting the height of the platform relative to the base.

8. The apparatus of claim 4, wherein the means for obtaining stereotactic X-ray images, means for compressing the pendulantly presented breast and means for guiding a biopsy needle have a range of rotation relative to the breast-receiving aperture of at least 180°

and less than 360°

as measured from an axis extending from the first end of the platform to the second end of the platform.

9. A method for using a prone stereotactic guided needle breast biopsy apparatus to sample an area of interest in a breast, the method comprising the steps of:

(a) providing a prone stereotactic guided needle breast biopsy apparatus, the apparatus further comprising;

a base,

a pedestal extending upwardly from the base,

a platform supported by the pedestal, the platform having a first end, a second end, and a breast-receiving aperture pertaining pendulant presentation of a patient'"'"'s breast therethrough, wherein the breast-receiving aperture is positioned on the platform so as to divide the platform into a first supporting portion extending from the first end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a first patient position and a second supporting portion extending from the second end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a second patient position,

a positionable ledge extending outwardly from the pedestal below the platform,

means for obtaining stereotactic X-ray images of the patient'"'"'s breast pendulantly presented through the breast-receiving aperture in the platform, the means being supported by the positionable ledge,

means for compressing the pendulantly presented breast, the means being supported by the positionable ledge, and

means for guiding a biopsy needle into the pendulantly presented and compressed breast, the means being supported by the positionable ledge,

wherein supporting a patient on the first supporting portion of the platform in a first patient supporting position enables the patient'"'"'s breast to be pendulantly presented through the breast receiving aperture in a first orientation with respect to the breast-receiving aperture, the means for obtaining stereotactic X-ray images, the means for compressing the breast and the means for guiding a biopsy needle by positioning, and whereby supporting a patient on the second supporting portion of the platform in a second patient supporting position enables the patient'"'"'s breast to be pendulantly presented through the breast-receiving aperture in a second orientation with respect to the breast-receiving aperture, the means for obtaining stereotactic X-ray images, the means for compressing the breast and the means for guiding a biopsy needle;

(b) determining the approximate location of the area of interest in a patient'"'"'s breast;

(c) determining whether the first orientation or the second orientation of the pendulantly presented breast enables biopsy needle access to the area of interest with a minimal needle path length from the needle guiding means;

(d) positioning the patient on the platform to enable biopsy needle access to the area of interest with a minimal needle path length from the needle guiding means in accordance with the determination in step (c);

(e) compressing the pendulantly presented breast so as to obtain a compressed pendulantly presented breast;

(f) imaging the compressed pendulantly presented breast so as to obtain stereotactic images of the area of interest therein;

(g) determining the three dimensional location of the area of interest from the stereotactic images thereof obtained in step (f); and

(h) inserting a biopsy needle into the compressed pendulantly presented breast at the three dimensional location determined in step (g) so as to obtain a sample of breast tissue in the area of interest.

10. A method for using a prone stereotactic guided needle breast biopsy apparatus to sample an area of interest in a breast, the method comprising the steps of:

(a) providing a prone stereotactic guided needle breast biopsy apparatus, the apparatus further comprising;

a base,

a pedestal extending upwardly from the base,

a platform supported by the pedestal, the platform having a first end, a second end, and a breast-receiving aperture permitting pendulant presentation of a patient'"'"'s breast therethrough, wherein the breast-receiving aperture is positioned on the platform so as to divide the platform into a fast supporting portion extending from the first end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a first patient position and a second supporting portion extending from the second end to the breast-receiving aperture for supporting at least a patient'"'"'s torso and legs in a second patient position,

a positionable ledge extending outwardly from the pedestal below the platform,

means for obtaining stereotactic X-ray images of the patient'"'"'s breast pendulantly presented through the breast-receiving aperture in the platform, the means being supported by the positionable ledge,

means for compressing the pendulantly presented breast, the means being supported by the positionable ledge, and

means for guiding a biopsy needle into the pendulantly presented and compressed breast, the means being supported by the positionable ledge,

wherein supporting a patient on the first supporting portion of the platform in a first patient supporting position enables the patient'"'"'s breast to be pendulantly presented through the breast receiving aperture in a fast orientation with respect to the breast-receiving aperture, the means for obtaining stereotactic X-ray images, the means for compressing the breast and the means for guiding a biopsy needle by positioning, and whereby supporting a patient on the second supporting portion of the platform in a second patient supporting position enables the patient'"'"'s breast to be pendulantly presented through the breast-receiving aperture in a second orientation with respect to the breast-receiving aperture, the means for obtaining stereotactic X-ray images, the means for compressing the breast and the means for guiding a biopsy needle;

(b) determining the approximate location of the area of interest in a patient'"'"'s breast;

(e) determining whether the first orientation or the second orientation of the pendulantly presented breast enables biopsy needle access to the area of interest from the underside of the breast;

(d) positioning the patient on the platform to enable biopsy needle access to the area of interest from the underside of the breast in accordance with the determination made in step (c);

(e) compressing the pendulantly presented breast so as to obtain a compressed pendulantly presented breast;

(f) imaging the compressed pendulantly presented breast so as to obtain stereotactic images of the area of interest therein;

(g) determining the three dimensional location of the area of interest from the stereotactic images thereof obtained in step (f); and

(h) inserting a biopsy needle into the compressed pendulantly presented breast at the three dimensional location determined in step (g) so as to obtain a sample of breast tissue in the area of interest from the underside of the breast.