Experience with breast biopsies using the Advanced Breast Biopsy Instrumentation system

A retrospective review of our experience with advanced breast biopsy instrumentation (ABBI) was undertaken to evaluate its efficacy for excisional breast biopsy of lesions detected on mammography. To our knowledge, experience with ABBI has not been previously reported in the radiology literature.

Biopsies using the ABBI system and an adapted dedicated table were performed in 53 patients who had 54 mammographically evident lesions. Samples were obtained with cannulas ranging in size between 5 and 20 mm. Indications for biopsy were calcifications (n = 22) and masses (n = 31).

Forty-five specimens (44 patients) had benign results at pathology: 15 specimens were diagnosed as fibroadenoma, 15 as cystic breast disease, and four as reactive lymph nodes; the remaining 11 specimens had benign diagnoses of adenosis, fibrosis, and hyperplasia. The average specimen size was 4.8 cm in greatest longitudinal dimension. One patient had a nondiagnostic biopsy for calcifications later found to be dermal. Seven patients were diagnosed as having breast cancer; in six of these, the tumor involved the margins of the specimen. One patient had marked atypia that required reexcision for the diagnosis of intraductal carcinoma to be made.

The ABBI procedure is a more invasive and less readily available procedure than core needle biopsy for sampling of benign breast lesions. In seven cases of malignancy diagnosed at breast biopsy, the ABBI technique completely excised only a single lesion. In our experience, the ABBI procedure offered no advantages over core needle biopsy for either benign or malignant lesions.