ADVANCED BREAST BIOPSY INSTRUMENTATION - A CRITIQUE

Background: Large-core biopsies or open biopsies with needle localizat ion have been the mainstay of treatment for evaluating nonpalpable mam mographic abnormalities. The newly introduced Advanced Breast Biopsy i nstrumentation (ABBI) system combines digital stereotactic imaging wit h a highly developed single-use biopsy device to locate and remove a r adiographically discovered breast lesion to an accuracy of I mm. Study Design: We conducted a review of the first 58 cases involving the use of the ABBI system. This: article evaluates the accuracy of specimen targeting, the success rate of lesion removal, the operative complicat ions, the mechanical difficulties, and patient satisfaction with the A BBI system. Results: The lesion was removed successfully in 47 of the 58 cases. Nine patients were eliminated in initial screening and the p rocedure could not be completed in two. Although the success rate was high, 14 of the procedures required conversion to ''open'' ABBI proced ures for completion of the biopsy. Conclusions: The ABBI system is an alternative to open biopsy with needle localization or large-core biop sy for nonpalpable mammographic abnormalities. This technique allows c omplete removal of the lesion in a onestep procedure. The ABBI system has certain limitations and mechanical problems, at least currently, a nd offers an advantage over current diagnostic modalities in a very li mited number of cases only. (C) 1997 by the American College of Surgeo ns.