Use of advanced breast biopsy instrumentation while performing stereotactic breast biopsies: review of 150 consecutive biopsies1

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Abstract
Background: Stereotactic breast biopsies are being performed in the United States with increasing frequency. Advanced breast biopsy instrumentation (ABBI) is a recent addition to the list of available stereotactic breast biopsy devices (eg, fine-needle aspiration, automated needle cores, and vacuum-assisted devices). Indications for the ABBI procedure in the management of patients with nonpalpaple mammographic lesions have not been established. Study Design: Prospectively collected data on 150 patients biopsied with the ABBI procedure were reviewed. Results: From April 1996 to May 1997, 150 patients with indeterminate or suspicious nonpalpable mammographic lesions were biopsied using the ABBI technique. Complications were minor. One patient (0.6%) required a repeat biopsy because of insufficient tissue and one patient had repeat excision to confirm the diagnosis of atypical ductal hyperplasia. Cancer was diagnosed in 26%. Followup mammograms were obtained in 94% of the patients. Lesions were missed in three patients (2%), none of whom were later found to have cancer. One patient (0.6%) required a repeat ABBI biopsy for postbiopsy architectural distortion. Postprocedure mammographic scarring was otherwise minimal and was noted in only 16% of the patients. Of the 111 patients with benign diagnoses, 67 were seen for clinical followup; 98% had good cosmetic outcomes and were satisfied with the ABBI technique. Conclusions: The ABBI technique is a safe, reliable stereotactic breast biopsy technique that is well accepted by patients. The sensitivity and specificity of ABBI biopsy for the diagnosis of carcinoma in this series were each 100% for the 142 patients returning for followup. Indications for the technique are similar to those for traditional needle localization excisional breast biopsies.