Advanced breast biopsy instrumentation for the evaluation of impalpable lesions: A reliable diagnostic tool with little therapeutic potential

Objective: To assess the potential of advanced breast biopsy instrumentatio n (ABBI) to clarify the diagnosis of impalpable mammographic lesions and to remove the entire malignant lesions with clear margins. Design: Prospective assessment in a consecutive series of patients. Setting: University hospital, Basel, Switzerland. Subjects: 139 patients presenting with 144 impalpable microcalcifications o r solid nodular densities evident on screening and follow-up mammograms tha t were suspicious of malignancy. Main outcome measures: Feasibility, sensitivity, efficiency in obtaining de finitive diagnoses in an outpatient clinic under local anaesthesia, feasibi lity of complete removal of a primary malignancy, and intervention-related morbidity. Results: The ABBI procedure was successful in 135/144 (94%); an accurate di agnosis was made in 129/130 patients followed up (99%), sensitivity for mal ignant lesions was 31/32 (97%) and there were 2 complications (2%). Margins of the biopsy cylinder contained a malignant lesion in 26/31 (84%). Conclusions: Excisional biopsy using the ABBI system is a reliable diagnost ic tool with a low morbidity. As in other published series margins were oft en not clear of tumour and therefore the therapeutic use of the ABBI proced ure is limited.