Initial experience with the advanced breast biopsy instrumentation device

OBJECTIVE. The Advanced Breast Biopsy Instrumentation (ABBI) device (United States Surgical; Nonvalk, CT) is designed to percutaneously excise nonpalp able breast lesions. Because this is a new technique, we report our initial experience with regard to technical success, complications, and histologic margins for malignancies. SUBJECTS AND METHODS. From May 14, 1997, until March 4, 1998, 89 consecutiv e patients elected to undergo the ABBI procedure. Preprocedure imaging incl uded screening mammography and additional mammographic and sonographic stud ies when deemed necessary. Lesions were targeted by the surgeons. Specimen radiography was performed for all lesions, and the images were interpreted by radiologists. Pathologic analysis was provided or reviewed by a dedicate d breast pathologist. Parameters analyzed included technical success, compl ications, lesion size, histologic diagnosis, and margin status for malignan t lesions. RESULTS. There were 29 patients with 30 noncalcified masses, 53 patients wi th clustered calcifications, three patients with masses and calcifications, three patients with asymmetric densities, and one patient with architectur al distortion. Eighteen ABBI procedures were aborted, converted to core bio psy, or failed to remove the targeted lesion. Fifteen patients experienced a total of 19 complications; 10 of the complications required treatment and followup after the biopsy. Of 11 malignant tumors revealed by ABBI, four h ad negative margins. Seven of these 11 malignant tumors had positive margin s. CONCLUSION. The ABBI procedure had a high number of complications and techn ical failures and did not reliably provide cancer-free margins for malignan t tumors. Women with nonpalpable breast lesions that need a tissue diagnosi s are better treated by stereotactic or sonographically guided needle biops y.