Early experience with breast biopsies using the Advanced Breast Biopsy Instrumentation (ABBI)

ABBI system is a new approach of non palpable breast lesions. The obyective of this study is to evaluate the efficacy and results with ABBI system. Between July 1999 and February 2000, 45 women have undergone excisional breast biopsy using ABBI system. All patients (pts) had non-palpable mammographic lesions. Inclusion criteria have been microcalcifications, nodular densities or architectural distortion not detected by US. Parameters analyzed have included techical success, time required for the procedure, postoperative complications, istologic diagnosis and patient's satisfaction. Of the 45 lesions removed with ABBI system, 29 (64.4%) were microcalcifications, 9 (20%) were nodular densities and 7 (15.6%) were architectural distortion. The procedure has been carried out under local anaesthesia. No intraoperative complications have been observed. Mean operative time has been 20 minutes. The procedure has been well tolerated by all the pts. Histologically, 4 (8.9%) lesions have resulted to be malignant, whereas 41 (91.1%) benign. 2 in situ carcinoma and 2 invasive ductal carcinoma were diagnosed. ABBI is an effective new form of minimally invasive breast surgery. It provides complete excision of mammographicabnormalities with minimal removal of adjacent normal tissue. Advanced Breast Biopsy Instrumentation (ABBI) system (United State Surgical Corporation and Lorad Corporation), is a new form of minimally invasive breast surgery: it offers an alternative and a less invasive approach to suspicious, non palpable mammographic abnormalities. In the last 20 years the increased women's attention toward breast cancer, the diffusion of breast ultrasound and mammography and the evolution of breast imaging has made the identification of sub-clinical breast lesions easier: in fact only the early detection of breast cancer by screening mammography can led to increased survival. The diffuse use of screening mammography has led to the identification of many more non palpable breast lesions (NPBL). It is expected that the number of breast biopsies will increase, especially for non palpable lesions: with this term we define breast lesions detected only by mammography or ultrasound. The literature reveals that beetwen 15% and 30% of these non palpable lesions are positive for malignancy. The current standard of care in evaluating non palpable breast lesions includes core biopsy using stereotactic mammography or ultrasound and "open" biopsy in the operating room using mammographic needle localization. Only the latter technique offers complete removal of the lesion allowing definitive diagnosis. The last diagnostic approch to non palpable breast lesions is ABBI system (United State Surgical Corporation and Lorad Corporation) which offers a less invasive approach when compared with the open biopsy, in addition to an accurate localization and a total excision of the areas. Reported advantages of ABBI system include a one step process, a smaller amount of breast tissue and at the same time a greater accurancy, approximately of +/- 1 mm, a less disfiguring biopsies, an accurate control intraoperatory of the procedure, a local anaesthesia, a decreased cost and a higher patient satisfaction. The purpose of this study is to present our experience with the initial 45 ABBI procedures performed by a single surgeon in our department and to evaluate the efficacy and results of ABBI system for stereotactic excisional biopsies of NPBL. Lastly the role of ABBI system as a potential therapeutic technique is discussed in the management of 1 of our patients.