Background: Needle localization and excision have been the preferred techni
ques for treating nonpalpable mammographic abnormalities. Recently, a less
invasive approach, using the Advanced Breast Biopsy Instrumentation (ABBI)
system, was introduced. This study was undertaken to determine the feasibil
ity, utility, and cost of this new alternative approach.
Methods: Between April 1996 and May 1997, 100 consecutive women underwent e
xcisional breast biopsies using the ABBI system. Demographic information, m
ammographic findings, pathological findings, hospital/professional fees, co
mplications, and subsequent interventions were documented.
Results: Excisional biopsies using the ABBI system were successful for 99 w
omen (average age, 62 years; range, 34-87 years). Of the 99 lesions removed
with the ABBI system, 27 were microcalcifications, 60 were suspicious soli
d nodules, and 12 were nodules with microcalcifications. The ABBI system wa
s used in an outpatient surgical setting, with only one patient requiring s
edation (because of anxiety). Cancer was seen in the biopsy specimens for 1
8 patients, seven of whom (35%) exhibited no residual tumor at the time of
definitive treatment. Postoperative hematomas occurred in two patients; one
hematoma required surgical drainage. One missed cancer was detected in fol
low-up mammograms 6 months after biopsy. The total average procedural cost
was $3406.44 +/- 486.63.
Conclusions: Excisional breast biopsy using the ABBI system is an effective
diagnostic method. It has a low complication rate, and its cost is compara
ble to that of classical needle localization.