Recent developments in stereotactic breast biopsy methodologies: An updatefor the surgical pathologist

Recently, there have been a number of new devices introduced for stereotact ic biopsy of nonpalpable, mammographically detected lesions. The vacuum-ass isted core biopsy (VACB) (Minimal Invasive Breast Biopsy (MIBB), U.S. Surgi cal, Norwalk, CT; Mammotome, Biopsys Medical, Cincinnati, OH) obtains multi ple tissue cores (Il-gauge) in a circumferential manner around the biopsy p robe, inserted under stereotactic guidance. It provides more complete sampl ing of mammographic lesions than the conventional 14-gauge stereotactic cor e biopsy, reducing the number of unsatisfactory biopsies. The advanced brea st biopsy instrumentation (ABBI) (United States Surgical Corporation, Norwa lk, CT) system utilizes stereotactic technique and an oscillating blade-cut ting mechanism to obtain a single large diameter (5mm to 20mm)tissue core, with the aim of obtaining an intact lesion in its entirety for histologic a ssessment. Its potential as a treatment option is still under investigation . Suggested protocols for specimen handling are presented together with a r eview of the recent literature. Close liaison with radiologists and surgeon s performing these biopsies will allow the collection of further outcome da ta to evaluate the strengths and weaknesses of each technique.