Initial experience with the advanced breast biopsy instrumentation system

Background: Advanced breast biopsy instrumentation is a recently designed alternative to large-core stereotactic and open needle localized breast biopsies. This minimally invasive technique uses digital stereotactic imaging to perform excisional biopsies of suspicious, nonpalpable mammographic lesio...

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Bibliographic Details
Published in:The American journal of surgery 1999-02, Vol.177 (2), p.97-101
Main Authors: Matthews, Brent D, Williams, Gary B
Format: Article
Language:English
Subjects:
Abnormalities
Anesthesia
Biological and medical sciences
Biopsy
Biopsy - adverse effects
Biopsy - instrumentation
Breast - pathology
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Carcinoma
Chemotherapy
Complications
Cost effectiveness
Digital imaging
Dissection
Equipment Design
Evaluation Studies as Topic
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Hematoma
Hospitals
Humans
Instrumentation
Instruments
Invasiveness
Lesions
Lumpectomy
Mammography
Medical sciences
Patients
Postoperative infection
Radiation
Radiation therapy
Retrospective Studies
Tumors
Work stations
Wound infection
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Summary:Background: Advanced breast biopsy instrumentation is a recently designed alternative to large-core stereotactic and open needle localized breast biopsies. This minimally invasive technique uses digital stereotactic imaging to perform excisional biopsies of suspicious, nonpalpable mammographic lesions. The role of the ABBI system in the management of breast cancer has not yet been defined. Methods: A retrospective review to evaluate the safety, accuracy, and cost effectiveness of the ABBI system as performed by a single surgeon on 107 patients from February 1, 1997 to January 31, 1998. We also discuss the use of the ABBI system as a therapeutic breast cancer technique. All patients had nonpalpable mammographic lesions. The mammographic abnormalities were either architectural distortion, microcalcifications, or stellate and nodular densities. Results: Using the ABBI stereotactic unit, 110 breast biopsies were performed in 107 patients during a 12-month period. The mammographic abnormality was accurately localized and successfully biopsied in 99% (109 of 110) of the procedures as confirmed by specimen radiographs, stereotactic images, permanent pathologic sections, and 6-month follow-up mammograms. There were no intraoperative complications. Two patients developed postoperative wound hematomas and there was 1 postoperative wound infection. Six in situ cancers and 21 invasive cancers were diagnosed with the ABBI system. Two additional invasive cancers were diagnosed in patients with ductal carcinoma in situ at reexcision. Four patients with invasive ductal carcinoma and 1 patient with ductal carcinoma in situ had negative margins on their stereotactic biopsies and did not undergo reexcision by lumpectomy or mastectomy. Each of the 4 patients with invasive ductal carcinoma underwent axillary node dissections with postoperative radiation therapy and chemotherapy or tamoxifen. During the study period, the average hospital patient charge for a stereotactic breast biopsy was $2,377.75, and for an open excisional needle localized biopsy it was $3,028.00 ( P
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(98)00311-0