An experience with the Advanced Breast Biopsy Instrumentation (ABBI) system in the management of non-palpable breast lesions

Abstract

Our objective was to evaluate our experience with the Advanced Breast Biopsy Instrumentation system (ABBI) in non-palpable breast lesions in a prospective study from July 1998 to November 2000. The ABBI system was included in a protocol for BIRADS 4 non-palpable, small (<15 mm) breast lesions. Digital radiographs of both specimen and biopsy cavity were obtained to validate the procedure. A total of 255 ABBI biopsies were performed in 254 patients. In 251 cases the lesions were successfully removed (98.4%). Mammographic lesions consisted of 176 cases of microcalcifications (69%), 51 cases of architectural distortions (20%) and 28 cases of nodules (11%). Seventy-two carcinomas were diagnosed (28.2%). Affected margins were found in 41 cases (56.9%). Residual tumour was seen in 31 patients (43%). Seventeen borderline results and 33 benign architectural distortions obviated further procedures. The complication rate in 10 cases was as follows: 3 wound infections; 4 haematomas; and 3 vasovagal reactions. The main utility of the ABBI system is to allow a reliable diagnosis in complex lesions, such as small clusters of microcalcifications and especially architectural distortions. Surgery can be avoided for borderline cases if the lesion is completely removed and free margins are obtained in the pathology study. Therapeutic use is controversial and can be applied only in selected cases.

Mammotome: Less Invasive than ABBI with Similar Accuracy for Early Breast Cancer Detection

“…Thus the two series investigated by the same medical team are comparable even though the ABBI population is a historical control. Moreover, our rate of malignancy is comparable to that in several published stereotactic biopsy series [3, 9, 11, 15, 17].…”

“…The rate of malignancy was comparable in the two groups and within the range of various recently published consecutive series of stereotactic breast biopsies [3, 9, 11, 15, 17]. The detected histologic findings are outlined in Table 3.…”

“…The advanced breast biopsy instrumentation (ABBI; United States Surgical Corporation, Norwalk, CT, USA) as one of the first stereotactically imaging instruments has been established with high accuracy [1][2][3][4][5][6][7][8][9][10][11]. Disadvantages of this method are its time-consuming complexity and the residual scar, with a length of 10 to 30 mm depending on the caliber of the cutting cannula used.…”

Site‐select procedure for non‐palpable breast lesions: Feasibility study with a 15‐mm cannula

“…This compares well with reported complication rates of other procedures, that is 2%-4% with ABBI [8], 0.3%-4% with stereotactic breast biopsy [13], and 0.2%-6% with ''open'' surgery [14,15]. Technical aspects A plastic cannula is inserted through a skin incision while an oscillating circular blade within the cannula incises the breast tissue…”

Predicting complete removal of impalpable breast carcinomas using stereotactic radiologically guided surgery

“…The lesion cannot always be removed successfully1, and the biopsy margins are often affected2. However, with growing experience and improving case selection, these drawbacks have largely been overcome3, 4. The most suitable lesions are either nodules or very well circumscribed clusters of microcalcification less than 15 mm in diameter.…”