Advanced Breast Biopsy Instrumentation: Stereotactic Excisional Breast Biopsy for Nonpalpable Lesions

Yang, Jung Hyun; Lee, Hae Kyung; Jung, Sung Hoo; Nam, Seok Jin; Lee, Byung Boong

Abstract

BACKGROUND: Stereotactic core biopsy has been advocated as an alternative to open biopsies with needle localization which had been the mainstay of treatment for evaluating nonpalpable mammographic abnormalities. Recently, the ABBI (Advanced Breast Biopsy Instrumentation) system was developed. It enables complete removal of the entire lesion with local anesthesia and ambulatory care.
METHODS
We analysed our results for 110 cases of nonpalpable mammographic lesions revealed by stereotactic core biopsies using a 14-gauge needle (n=42) or stereotactic excisional biopsy using the ABBI system (n=68) since December 1997 at the Samsung Medical Center.
RESULTS
Of the 110 cases, 13 cases of malignancy were diagnosed, including 9 cases (69%) of DCIS (ductal carcinoma in situ). The pathologic results of the 6 cancers revealed by stereotactic core biopsy had same as the results from the surgical specimens including 5 DCIS and one infiltrating ductal carcinoma. Of the 7 cancers revealed by the ABBI system 4 were DCIS, 1 was LCIS (lobular carcinoma in situ), 1 was an infiltrating ductal carcinoma, and 1 was a mucinous carcinoma. Needle localization biopsy was performed in 5 patients who had benign results from the stereotactic core biopsy, despite the existence of mammographically suspicious lesions. Of these, 2 DCIS cases were finally revealed.
CONCLUSIONS
The ABBI system is more ideal than stereotactic core biopsy and allows the advantageous replacement of needle localization and excisional biopsy in selected patients.