The Advanced Breast Biopsy Instrumentation (ABBI) experience at a community hospital

The Advanced Breast Biopsy Instrumentation (ABBI; U.S. Surgical Corp., Norw alk, CT) system is the newest technology available for the evaluation and d iagnosis of nonpalpable breast lesions. It requires the breast imaging spec ialist, often a radiologist, to localize the suspicious lesion to x, y, and z coordinates in a digital mammogram unit. The coordinates are then used b y the surgeon to operate and direct the ABBI biopsy device around the lesio n to obtain an excisional biopsy. Mammographic confirmation of the specimen is then immediately obtained. First introduced in the United States in Apr il 1996, the ABBI system is aimed at rivaling the previously relied upon me thods of needle-localized and core needle breast biopsies. In this study, w e analyzed the first 15 months of use of the ABBI system in a community hos pital to evaluate its applicability and efficacy in the diagnosis of nonpal pable breast lesions. Eighteen surgeons and three radiologists performed a total of 230 cases on 223 patients (seven patients had bilateral breast bio psies). The lesions biopsied included 114 clustered microcalcifications, 11 5 masses, and 1 retained guidewire from a previous needle-localized breast biopsy. The average time for the complete procedure was 65 minutes. Breast cancer was identified in 36 patients (36 of 230, 15.7%) and 1 additional pa tient had an incidental finding of lobular carcinoma in situ. The malignanc ies included 20 cases of invasive ductal carcinoma, 12 cases of ductal carc inoma in situ, and four cases of invasive lobular carcinoma. Overall, 84 pe r cent of the patients had a definitive benign diagnosis and required no fu rther surgical treatment of their mammographic finding. There have been no known missed lesions after use of the ABBI procedure. In conclusion, our ex perience has shown the ABBI system to be a valuable option in the managemen t of selected patients with nonpalpable breast lesions.