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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2005 August;18(4):175-80
Non-palpable breast lesion-biopsy by ABBI® system. A diagnostic tool
Rulli A., Lauro A., Bisacci C., Cirocchi R., Carli L
Aim. Deaths from breast cancer are falling because of therapeutic advances and an increased use of screening mammography but, as more women are screened, more of them will need breast biopsy. FNA is not always adequate, so the number of surgical procedures for non-palpable breast lesions (microcalcifications, parenchymal distorsions, less than 10 mm-nodules and nodules plus microcalcifications) is increasing, although most of them are benign lesions. There is a need to improve the quality of the biopsy, to select the patients to bring into the operating-room and to obtain a better cost-effectiveness: we report our experience with the ABBI® system (Advanced Breast Biopsy Instrumentation-Autosuture Company) as a diagnostic tool.
Methods. The ABBI® system is an X-ray digital system with a mechanical arm guided by computer-targeting, able to drive a biopsy-needle inside the lesion or to remove a breast area (up to 20 mm) by special cannules, under local anesthesia: it is anatomically shaped, with head and shoulders on same level and relaxed pectoralis muscles, allowing a more precise procedure. In 1 year, we performed 141 procedures (59 excisional biopsies and 82 core-biopsies): 98 of them were benign lesions.
Results. We removed 30 nodules (22 benign and 8 malignant), 23 microcalcifications (13 benign and 10 malignant), 5 nodules plus microcalcifications (5 benign) and 1 parenchymal distorsion (1 benign). There were no relevant complications in our series (1 hematoma, spontaneously healed). We performed multiple core-biopsies on 82 patients as well: 63 nodules (45 benign and 18 malignant), 10 microcalcifications (9 benign and 1 malignant), 5 nodules plus microcalcifications (3 benign and 2 malignant) and 3 parenchymal distorsions (3 malignant). One lesion was MRI-positive only.
Conclusion. ABBI® system is a safe, cost-effective, technically easy and fast (up to 15 min) day-case procedure: it allows a good cosmetic result and, in case of benign histological findings, a one-step procedure. In our experience, more than 69% of core- or excisional-biopsies were benign and didn¹t go to the operating room: ABBI® is going to represent an ideal, accurate diagnostic tool in the management of non-palpable breast lesions.